^ 


Presented  in  honor  of 
Alfons  I.  Wray,  D,0,,  F.O.C.O. 


COLLEGE    OF    OSTEOPATHIC    PHYSICIANS 
AND  SURGEONS  •    LOS  ANGELES,  CALIFORNIA 


**•       *. 


PRACTICAL  VISIONS 

A  Book  °f  Inspiration  / 


F.  P.  MILLARD,  D.  0. 

Founder  and  President  of  The  National  League  for  the  Pre- 
vention of  Spinal  Curvature;  Founder  and  President  of 
the  International  Society  for  Lymphatic  Research;  Editor 
of  a  Quarterly  Journal  Published  by  that  Society;  Ana- 
tomical Artist,  Originator  of  Watermarked  Spine  in  Sta- 
tionery for  the  Osteopathic  Profession;  Author  of  Poliomye- 
litis; Author  of  Applied  Anatomj  of  The  Lymphatics. 


COPYRIGHT,  1922 

BT 

F.  P.  MILLARD 


Dedicated  to  My  Old  Friend 

DR.  C.  C.  REID 
who  first  introduced  Osteopathy  to  me 


PREFACE 

Many  books  have  been  written  along  inspirational 
lines.  It  would  be  quite  impossible  to  cover  new  ground, 
so  to  speak,  as  there  is  supposedly  "nothing  new  under 
the  sun. " 

The  favorite  subjects  of  some  of  the  greatest  writers 
and  speakers  in  history  have  been  inspirational  in  character. 

The  title  of  this  book  indicates  that  we  intend  to  dis- 
cuss practical  phases. 

In  the  study  of  anatomy  in  our  colleges  we  consider 
the  human  body  along  the  lines  of  regional  anatomy,  sec- 
tional anatomy,  surgical  anatomy,  and  so  forth.  There  is 
another  phase,  of  vital  importance  to  all  practitioners  of 
the  therapeutic  art,  and  that  is  applied  anatomy. 

We  hear  much  about  visions  today.  The  slogan, 
printed  in  various  magazines,  "Where  There  Is  No  Vision, 
The  People  Perish,"  is  pretty  well  impressed  upon  the 
minds  of  the  majoritjr  of  people.  We  have  found  that  it  is 
all  well  and  good  to  have  visions  and  dreams,  and  "raise 
our  vibrations"  to  a  point  where  we  feel  that  we  are  in- 
spired, and  can  dream  dreams  that  will  materialize;  but  how 
many  of  our  dreams  really  come  true,  and  how  many  can 
we  use  from  a  practical  standpoint  in  our  everyday  prac- 
tice? 

This  book  is  directed  to  graduates  of  osteopathic  col- 
leges; especially  to  thos^  graduates  who  have  the  osteo- 
pathic concept;  who  have  studied  osteopathy  intending  to 
practice  it  according  to  the  teachings  of  the  great  founder, 
Dr.  A.  T.  Still. 

We  do  not  wish,  in  this  book,  to  consider  those  who 
have  chosen  other  than  osteopathic  methods  of  treating 
the  human  body.  In  writing  of  our  experience,  which  cov- 

—5— 


J3327 


6  PRACTICAL  VISIONS 

era  a  period  of  more  than  twenty-two  years,  we  mean  to 
present  thiijgs  just  as  we  have  worked  them  out  in  the  office 
and  as  we  have  written  them  in  the  various  journals. 

While  this  book  is  written  for  graduates  of  osteopathy 
who  are  entering  practice,  we  trust  that  there  will  be  points 
of  interest  to  those  who  have  been  practicing  for  some  years. 
We  have  also  included  a  few  chapter  that  will  be  of  inter- 
est to  those  who  are  students;  likewise,  a  chapter  to  those 
contemplating  the  study  of  osteopathy. 

We  do  not  wish  to  say  anything  that  is  not  practical 
in  nature,  or  which  cannot  be  carried  out  in  the  office  of 
any  osteopathic  physician,  if  he  is  practicing  osteopathy 
as  taught  by  Dr.  Still. 

We  will  leave  it  to  others  to  write  on  various  methods 
in  the  healing  art,  outside  of  the  specific  lesion  idea.  We 
consider  that  this  idea  is  the  basic  principle  in  osteopathy, 
and  that  it  will  be  as  long  as  osteopathy  is  practiced  as  a 
scientific  method  of  treating  human  ailments,  according 
to  the  teachings  of  the  Founder  of  our  Science. 

No  man  is  as  great  as  osteopathy,  and  no  man  will 
ever  be  able  to  work  out  all  of  the  principles  and  practice 
that  is  included  in  the  osteopathic  concept. 

After  practicing  over  twenty-two  years,  I  realize  that 
I  have  just  laid  the  foundation  stone  for  the  real  work  upon 
which  to  build  a  greater  osteopathic  structure,  and  I  hope 
that  some  day  my  vision  regarding  osteopathy,  will  be 
much  greater  from  a  practical  standpoint,  than  it  is  at  the 
present  time. 

There  always  will  be  among  us  those  who  have  visions 
greater  than  our  own.  Doctor  Still  had  a  vision,  away  back 
in  the  time  when  the  therapeutic  art  was  confined  almost 
entirely  to  the  older  school,  and  we  possibly  never  will  ap- 
preciate the  great  difficulties  he  encountered  in  launching  a 


PREFACE  7 

new  school,  absolutely  opposed  in  every  way  to  the  older 
school.  Yet  he  stood  firm  and  never  weakened  in  his  great 
effort  to  present  to  the  world  a  scientific  truth  that  will 
live  throughout  the  ages.  Doctor  Still  will  go  down  in 
history  as  the  greatest  original  and  forcible  thinker  ever 
known  in  therapeutics. 

Osteopathy  was  given  to  him  in  the  form  of  a  vision. 
This  is  a  well-known  fact,  and  had  it  not  been  of  a  practical 
nature,  it  never  could  have  worked  out  and  changed  the 
ideas  of  a  thinking  world.  His  vision  was  practical,  from 
a  physician's  standpoint,  or  he  never  could  have  adapted 
it  to  the  clinic  room,  bedside,  and  other  places  where  hu- 
man beings  suffer.  It  has  stood  the  test  of  time,  and  count- 
less numbers  have  been  relieved  by  the  therapeutic  measures 
he  worked  out. 

This  vision  was  of  such  a  practical  nature  that  it  brought 
conviction  in  his  own  mind,  and  apparently  it  lingered  in 
his  mind  in  the  form  of  an  outline  that  stood  before  him 
day  after  day,  like  a  program  that  requires  fulfilling  in 
order  to  be  complete  and  staisfactory. 

A  vision  of  this  kind  could  only  be  realized  and  ap- 
preciated by  a  great  mind.  Possibly  others  had  part  of  the 
same  vision  at  different  times,  but  only  the  great  mentality 
of  Dr.  Still  could  comprehend  the  practical  vision  that  was 
given  him.  Only  a  man  with  great  force,  tremendous  con- 
viction, iron  will,  and  undaunted  determination,  could  work 
out  a  program,  under  such  unusual  adversity,  carrying  his 
ideas  forward  to  a  point  of  satisfactory  completion  before 
being  called  Home. 

I  dare  say  that  no  person  ever  lived  who  did  not  have 
a  vision  of  some  kind,  either  in  the  way  of  a  dream  or  an 
impression  that,  at  least,  stimulated  greater  thought  and 
activity  in  some  manner.  Possibly  not  a  year  goes  by  that 


8  PRACTICAL  VISIONS 

we  do  not  have  some  form  of  impression,  or  dream,  or  vision, 
but  of  what  use  are  these  impressions,  or  dreams,  or  visions, 
unless  we  take  hold  of  them  and  build  upon  them  a  structure 
that  will  last  throughout  the  ages? 

No  two  human  brains  were  ever  created  exactly  alike, 
any  more  than  any  two  faces.  No  one  mind  can  compre- 
hend everything.  No  one  mind  can  handle  the  visions  that 
are  given  to  it,  in  their  entirety.  A  great  many  of  these 
are  simply  air  castles.  Apparently,  they  seem  very  good, 
but  when  thoroughly  thought  over,  they  seem  either  im- 
practicable or  too  great  a  task  to  work  out. 

Men  in  this  world  are  selected  to  do  great  things,  ac- 
cording to  the  visions  that  they  have.  Who  could  fill  the 
place  of  a  president  of  the  United  States  without  having  a 
broad  vision  that  includes  at  least  a  desire  to  preside  over 
the  many  states  of  the  Union  in  a  satisfactory  manner? 

What  man  could  carry  out  the  work  of  a  great  states- 
man, unless  he  had  a  practical  vision  which  would  lead  him 
on  to  build  a  structure  that  would  be  international  in  char- 
acter? 

Men  are  selected  for  great  tasks  according  to  their 
ability,  and  the  visions  back  of  this  ability. 

When  we  want  a  tunnel  put  under  the  Hudson  river, 
possibly  we  find  but  one  man  who  has  sufficient  vision  to 
carry  out  the  idea. 

When  we  wish  a  canal  dug  across  the  isthmus,  we  se- 
lect a  man  who  has  a  vision  sufficiently  broad  to  do  that 
work  in  a  satisfactory  manner. 

When  great  dams  are  to  be  built,  when  tunnels  are  to 
be  bored  through  the  mountains,  men  are  selected  who  have 
visions  sufficiently  strong  to  enable  them  to  convince  those 
who  have  charge  of  the  matter  that  they  are  capable  in 
every  respect  of  carrying  out  the  vision  or  dream. 


PREFACE  9 

Thus  in  all  forms  of  work,  in  all  the  various  branches 
of  science,  music,  art,  we  have  men  with  vision. 

Only  a  master  can  produce  an  oil  painting  that  will 
live  through  the  ages  and  command  respect,  attention,  and 
a  place  in  a  great  art  salon. 

The  greatest  generals  that  ever  lived  were  men  who 
had  practical  visions  that  enabled  them  to  carry  out  their 
great  schemes  and  bring  success  to  the  armies  over  which 
they  had  command. 

We  can  train  our  minds  to  a  point  where  we  may  re- 
ceive impressions  and  put  them  to  good  use.  The  majority 
of  human  beings  are  timid.  They  do  not  appreciate  the 
fact  that  they  have,  within  their  skulls,  a  varying  number 
of  ounces  of  cerebral  matter,  the  potentiality  of  which  can 
never  be  estimated,  the  capabilities  of  which  will  never  be 
understood,  and  the  number  of  superstructures  that  could 
be  built  upon  the  impressions  received  by  which,  can  never 
be  fathomed  by  the  human  mind 

No  man  has  ever  used  all  of  his  brain,  or  any  great 
portion  of  it,  possibly  due  to  lack  of  training,  possibly  from 
illness,  or  some  physical  handicap;  but,  if  we  only  under- 
stood the  capabilities  of  the  human  mind,  and  could  find 
instructors  sufficiently  capable  to  train  that  mind  and  bring 
out  all  of  the  phases  that  are  so  necessary  in  order  to  build, 
from  impressions  and  visions,  there  would  be  no  limit  to 
what  we  might  accomplish  in  every  instance. 

F.    P.    MlLLARD. 

Sept.  4th,  1922. 


CONTENTS 

CHAPTER  PAGE 

I.    SELECTING  A  LIFE'S  WORK 13 

II.    BUILDING  THE  FRAMEWORK 19 

III.  HONORING  YOUR  PROFESSION 27 

IV.  THE  FRESHMAN 35 

V.    THE  SOPHOMORE 43 

VI.    THE  JUNIOR 53 

VII.    THE  SENIOR 69 

VIII.    GRADUATION 79 

IX.    OPENING  AN  OFFICE 87 

X.    THE  PHYSICIAN  HIMSELF 95 

XI.    MAKE  A  FRESH  DIAGNOSIS  EVERY  DAY 105 

XII.     "NOT  THAT,  Bur  THIS" .113 

XIII.  ALERTNESS 121 

XIV.  "Do  IT  Now" .129 

XV.    AIR  CASTLES 135 

XVI.    GETTING  THE  PRACTICAL  VISION 141 

XVII.    SPECIFIC  TREATMENT 151 

XVIII.    DIAGNOSIS 157 

XIX.    BE  SPECIFIC ' 167 

XX.     "FORGET  IT" 177 

XXI.    CLINICS 185 

XXII.     FEES ..'........... .".  !l93 

XXIII.  LETTER  WRITING 203 

XXIV.  NEW  PATIENTS ,...../...'.  .209 

XXV.    TREATMEOT  ROOM . .  .217 

XXVI.    ADVERTISING .' 227 

XXVII.    RESEARCH V." 235 

XXVIII.     TREATING  CHILDREN 243 

XXIX.    OFFICE  ATTENDANTS 251 

XXX.  ATTITUDE  OF  A  PHYSICIAN  To  WARD  A  PATIENT  263 


CHAPTER  I 


SELECTING  A  LIFE'S 
WORK 


CHAPTER  I. 

SELECTING  A  LIFE'S  WORK 

Exactly  a  quarter  of  a  century  ago,  Dr.  C.  C.  Reid,  now 
one  of  the  best  known  osteopaths  in  the  world,  wrote  me,  at 
Denver,  Colorado,  where  I  had  gone  to  study  medicine, 
that  I  should  personally  investigate  osteopathy  at  once, 
and  that  he  was  at  Kirksville,  Mo.,  studying  osteopathy 
instead  of  medicine,  as  he  had  formerly  planned,  and  that 
everything  was  lovely  and  the  goose  hung  high. 

At  that  time  I  was  only  in  my  teens,  and  very  keen  on 
becoming  a  physician.  I  had  made  up  my  mind  to  study 
medicine,  to  specialize  in  surgery,  and  practice  surgery  the 
rest  of  my  life. 

Somehow  or  other,  the  letter  seemed  so  full  of  inspira- 
tion, and  he  seemed  so  deeply  convinced  that  he  had  found 
the  better  way  of  treating  human  ailments,  that  the  ex- 
pression used  in  his  letter,  "everything  is  lovely  and  the 
goose  hangs  high,"  thrilled  me  through  and  through. 

Well  do  I  remember  the  first  osteopathic  treatment 
that  I  ever  saw  given.  Also,  I  remember  well  the  first  pa- 
tient that  I  ever  talked  to,  who  had  been  cured  by  oste- 
opathy, after  going  about  on  crutches  for  quite  a  long  time 
and  considered  incurable. 

Investigation  regarding  the  new  science  stimulated  me 
to  such  an  extent  that  I  realized  the  absolute  truth  of  the 
statement  made  by  the  Old  Doctor,  that  the  body  is  a  ma- 
chine, and  that  if  we  would  make  any  headway  in  handling 
diseases  we  must  consider  the  body  from  a  mechanical 
standpoint  and  treat  accordingly. 

There  seemed  to  be  so  much  logic  about  osteopathy 
that  I  could  not  persuade  myself  to  continue  the  study  of 

—15— 


16  PRACTICAL  VISIONS 

medicine.  It  seemed  as  if  the  new  school  had  presented 
something  that  was  tangible,  real,  scientific,  and  out  of 
which  some  day  the  entire  world  would  be  benefited  directly 
or  indirectly,  through  the  teachings  of  the  Founder  of  this 
new  school,  called  osteopathy. 

Well  do  I  remember  the  first  copies  of  the  Journal  of 
Osteopathy,  the  first  osteopathic  publication  that  was  ever 
printed;  and  in  my  library  today  I  believe  I  prize  the  early 
copies  of  the  Journal  of  Osteopathy  more  than  any  other 
osteopathic  literature  that  I  have  in  my  possession.  There 
seemed  to  be  something  about  those  early  journals  that 
stimulated  and  thrilled  one  to  such  an  extent  that  he  felt 
as  if  the  real  truth  had  been  given  to  the  people  after  all 
these  centuries  of  therapeutic  study. 

When  a  young  man  decides  his  course  in  life,  the  sub- 
ject that  he  is  going  to  study,  the  profession  that  he  has 
chosen;  the  next  thing  he  thinks  about  is  what  particular 
branch  or  phase  of  the  subject  will  interest  him  most,  and 
what  part  of  the  work  seems  most  practical  and  most  adapted 
to  use  throughout  his  career.  Every  young  man  wants  to 
make  the  most  of  life;  his  great  desire  is  to  select  some  call- 
ing or  profession  into  which  he  can  put  his  whole  soul  and 
do  his  best  work. 

It  was  a  shock  to  me  to  have  to  give  up  my  early  dreams, 
in  which  I  pictured  myself  in  white  robes,  operating  in  some 
hospital  in  a  large  city;  but,  on  looking  back  over  the  twenty- 
five  years  since  I  first  started  the  study  of  osteopathy,  I 
have  no  regret,  and  were  I  to  choose  my  special  work  again 
along  the  healing  line,  I  would  walk  boldly  out  and  enter 
some  one  of  the  colleges  of  osteopathy,  and  with  enthusiasm 
go  through  the  range  of  subjects  and  secure  all  the  informa- 
tion that  I  could;  then  go  out,  proud  to  be  called  a  disciple 
of  Dr.  A.  T.  Still. 


SELECTING  A  LIFE'S  WORK  17 

Strange  it  is  how  some  one  comes  into  our  lives  and 
changes  our  entire  program.  This  is  a  common  occurrence, 
and  if  we  are  diverted  in  the  right  direction,  and  the  vision 
is  a  practical  one,  we  follow  our  work  throughout  life  with 
the  greatest  of  pleasure,  and  thrill  with  the  thought  that 
we  have  found  the  work  best  adapted  to  our  needs  and 
temperament. 

I  have  ever  been  glad  that  Dr.  C.  C.  Reid  came  to  my 
assistance  at  the  time  when  I  most  needed  guidance. 


(2) 


CHAPTER  II 


BUILDING  THE 
FRAMEWORK 


CHAPTER  II. 

BUILDING  THE  FRAMEWORK 

The  thrill  of  entering  college  the  first  day  lingers,  usual- 
ly, throughout  a  man's  life.  Many  are  the  thoughts  that 
run  through  the  mind.  In  the  first  place,  you  have  chosen 
your  calling.  In  the  second  place,  you  feel  that  you  can 
put  your  whole  soul  into  the  work.  In  the  third  place, 
your  great  desire  is  to  build  a  structure  that  will  last  at 
least  as  long  as  you  live. 

With  what  eagerness  you  listen  to  the  first  lectures  on 
a  subject  that  seems  of  such  vast  importance  to  you  as  a 
beginner,  and  later,  as  you  look  back,  is  still  of  vast  im- 
portance, in  that  it  was  the  foundation  of  the  work  upon 
which  you  accomplished  things  in  later  life. 

In  every  phase  of  life,  a  successful  man  is  one  who  fol- 
lows a  schedule;  also  one  who  has  system,  and  one  who  does 
not  neglect  each  day's  tasks.  This  is  the  secret  of  a  success- 
ful man.  fl>u^xv^A~^**i  »  **  t 

It  is  absolutely  necessary  to  lay  each  stone  well,  true 
to  line,  and  well  cemented,  if  you  wish  your  structure  to  last 
for  any  length  of  time. 

The  majority  of  students  who  enter  an  osteopathic 
college  are  sincere,  and  honestly  desire  to  secure  all  the 
information  that  can  possibly  be  had,  in  order  that  they 
will  feel  proficient  and  have  confidence  when  they  go  out 
into  the  field  to  practice.  Now  this  cannot  be  done  unless 
faithful  work  is  daily  done,  and  unless  a  schedule  is  followed, 
and  no  work  slighted. 

In  every  school,  almost  invariably,  the  teacher  takes 
more  interest  in  those  who  are  anxious  to  learn,  and  who 
are  keen  to  know  all  that  there  is  to  be  known,  as  nearly 
as  is  possible,  about  the  subject  that  is  under  discussion. 

—21— 


22  PRACTICAL  VISIONS 

The  gratification  that  a  student  has  on  examination 
day  in  knowing  that  he  has  written  his  papers  well,  is  be- 
yond description.  He  has  the  satisfaction  of  knowing  that 
he  has  applied  himself  during  the  term ;  that  he  has  followed 
closely  the  teachings  of  the  professors;  and  that  he  has  not 
neglected,  in  any  way,  any  chapter  of  the  subject.  There 
is  a  satisfaction,  at  the  close  of  the  college  career,  when  one 
receives  his  diploma  and  feels  within  himself  that  he  has 
honestly  pursued  his  studies,  and  tried  in  every  way  to  ac- 
quire all  of  the  knowledge  that  is  humanly  possible  during 
his  college  course. 

After  entering  the  field,  one  has  that  common  feeling 
that  he  has  just  started  in  life's  great  study.  If  a  student 
is  at  all  inclined  to  be  studious,  which  he  should  be,  he  will 
never  stop  studying,  as  the  longer  one  practices  the  healing 
art,  the  broader  the  field  becomes.  There  is  no  such  thing 
as  being  a  specialist  on  every  subject  in  therapeutics.  There 
is  sufficient  study  on  the  central  nervous  system  to  con- 
fine a  man's  research  work  and  clinic  work  to  an  entire 
lifetime  and  then  only  in  a  small  way  will  he  feel  that  he  is 
master  of  the  situation. 

It  is  a  question  whether  we  ever  will  know  all  of  the 
reflexes,  or  understand  entirely  the  autonomic  nervous 
system,  or,  in  any  way  comprehend  in  its  entirety  the  rela- 
tion between  the  various  nerve  centers  and  the  tracts  that 
convey  messages  to  all  of  the  organs  and  parts  of  the  body 
in  such  perfect  harmony  and  unison  through  a  peculiar  co- 
ordination of  the  central  nerve  cells  that  exist  in  the  brain 
and  spinal  cord. 

But  it  is  quite  possible  for  a  student  to  develop  his 
mind  to  an  extent  where  he  will  feel  that  he  can  diagnose  to 
a  certain  degree  the  various  conditions  found  in  the  patient 
under  observation. 


BUILDING  THE  FRAMEWORK  23 

It  is  also  a  question  whether  any  known  physician  at 
the  present  time,  or  during  the  past  ages,  has  ever  been  able 
to  make  more  than  fifty  percent  of  correct  diagnoses  in 
the  average  chronic  cases.  It  is  practically  humanly  im- 
possible for  a  physician  to  know  the  condition  of  the  tissues 
within  the  body  throughout  its  entirety.  Objective  and 
subjective  symptoms  portray  to  us  certain  existing  condi- 
tions, but  who  knows  when  a  cancer  begins,  or  who  knows 
the  beginning  even  of  locomotor  ataxia? 

The  student  of  today  is  better  fitted  than  the  one  of 
yesterday,  to  comprehend  the  manifestations  of  the  human 
body,  as  portrayed  in  clinical  pictures  written  out  by  the 
authors  of  the  best  text  books. 

This  need  not  discourage  the  student,  as  we  have  many 
examples  of  wonderful  physicians,  who  have  conducted 
practices  throughout  their  lives  on  a  very  high  order;  those 
who  have  written  text  books;  who  are  specialists;  who  have 
been  benefactors  of  the  human  race;  and  who  can  picture 
the  symptoms,  clinically,  in  a  manner  that  seems  almost 
marvelous. 

It  is  possible  for  a  sincere  student  so  to  familiarize 
himself  with  physiology,  applied  anatomy,  chemistry,  and 
all  of  the  various  subjects  taught  in  our  great  colleges  today, 
that  he  will  understand  the  human  body  sufficiently  to  give 
relief  in  the  majority  of  instances.  There  are  certain  cases 
that  baffle  the  greatest  of  physicians.  There  are  certain 
conditions  found  in  certain  cases  which  may,  although 
possibly  idiosyncrasies,  outwit  the  skill  of  any  human  phy- 
sician, and  the  disease  progresses,  according  to  the  clinic 
picture,  through  the  various  stages,  unto  an  untimely  end. 

It  is  impossible  for  any  physician  to  handle  every  form 
of  disease.  We  must,  therefore,  content  ourselves  with 
doing  the  greatest  amount  of  good  that  we  possibly  can, 


24  PRACTICAL  VISIONS 

and  securing  the  greatest  possible  knowledge  in  every  phase 
of  therapeutics,  and  leave  it  to  the  coming  generations  to 
point  the  way  to  a  greater  field  of  diagnosis,  in  which,  possi- 
bly, some  day  a  physician  may  be  able  to  discern  the  be- 
ginning of  diseases,  or  prodromal  symptoms  that  are  im- 
possible of  detection  at  the  present  time.  A  certain  stage  of 
a  disease  is  usually  reached  before  the  physician  makes 
the  diagnosis,  pronouncing  the  case  as  one  afflicted  with 
such  and  such  a  trouble.  If  this  were  not  true,  why  do 
men  under  constant  care  of  skilled  physicians  go  down  with 
typhoid,  or  some  other  disease,  and,  while  apparently  in 
perfect  health,  go  through  certain  stages  of  a  disease  that 
may  lead  to  death  or  chronic  conditions  that  no  one  dreamed 
of?  What  physician  can  say  that  a  certain  man  will  have 
locomotor  ataxia,  or  even  paralysis  agitans?  Or  what 
physician  would  dare  say,  in  all  certainty,  that  a  certain 
case  would  have  an  embolus  that  would  block  the  circula- 
tion and  put  the  patient  into  bed? 

We  have  no  way  of  telling  what  will  happen  to  the 
human  organism,  and  no  physician  can  say  with  sincerity 
that  he  can  cure  any  trouble;  even  the  scratch  of  a  pin,  or  an 
ingrown  toe  nail.  Blood  poison  often  overtakes  the  patient 
when  least  expected,  and  sometimes  in  spite  of  the  greatest 
of  skill  the  patient  dies  of  tetanus. 

It  is  well  for  a  student  to  keep  in  mind  that  after  all, 
no  matter  how  much  knowledge  he  may  attain,  it  is  not 
humanly  possible,  in  all  instances,  to  restore  his  patient, 
even  with  the  greatest  of  care  and  skill.  There  is  a  certain 
element  of  uncertainty  in  any  case,  and  it  should  serve  as  a 
hint  that  no  matter  what  case  we  have  under  our  care,  it 
deserves  the  very  best  skill  that  we  can  possibly  give  it. 

Many  a  case  that  seems  trifling  to  a  surgeon,  proves  in 
time  to  be  most  serious,  or  even  fatal. 


25 


There  is  no  such  thing  as  a  disease  or  condition  being 
trifling  in  the  human  body.  The  greatest  skill  that  we  can 
muster,  backed  up  by  the  greatest  amount  of  study  and 
research  that  we  can  possibly  accomplish,  should  be  centered 
upon  every  case  that  comes  under  our  observation.  This 
will  make  a  physician  successful  and  appreciated  by  the 
community  in  which  he  practices,  more,  possibly,  than  any 
other  one  point.  Sincerity  and  close  attention  to  each  case 
spells  success  for  any  physician  who  has  been  a  student  and  a 
careful  observer  of  conditions  in  the  human  body. 

Every  physician  should  be  a  research  worker,  a  con- 
stant student,  a  close  observer,  and  a  conscientious  worker, 
throughout  his  life  as  a  practitioner. 


CHAPTER  III 


HONORING  YOUR 
PROFESSION 


CHAPTER  III. 

HONORING  YOUR  PROFESSION 

When  Sir  Herbert  Barker  started  out  as  a  bone  setter, 
he  was  not  only  unrecognized  officially,  but  was  referred  to 
in  a  very  slighting  manner  on  many  occasions. 

Today,  the  knighting  of  this  wonderful  natural  worker 
has  done  more  to  make  members  of  the  art  of  drugless  heal- 
ing proud  that  they  belong  to  that  craft,  than  anything 
that  has  happened  since  Dr.  Still's  day. 

Years  ago  we  naturally  expected,  when  putting  up  our 
signs  as  osteopaths,  that  we  would  be  referred  to  often- 
times as  "irregulars,"  "quacks,"  and  even  "charlatans" 
and  "mountebanks."  In  fact,  I  think  I  have  been  called 
all  of  these,  as  well  as  a  great  many  more  terms  and  phrases, 
like  "pow-wow  doctor,"  "mesmerizer,"  "magnetic  heal- 
er, "  and  so  forth. 

People  become  confused  regarding  the  principles  of  a 
new  science  or  school  of  healing,  and  osteopathy,  along  with 
some  of  the  newer  schools,  has  often  been  ridiculed  in  a  very 
slighting  manner  by  those  who  really  did  not  take  the  pains 
to  go  into  the  matter  and  see  for  themselves.  Many  times 
in  early  days  we  found  it  most  embarrassing,  in  doing  pioneer 
work,  to  be  almost  openly  slurred  and  slighted  by  the  older 
school  and  its  followers. 

About  the  best  thing  I  ever  heard,  regarding  ethics  of 
one  of  the  "irregulars"  or  "quack  doctors,"  was  when  one 
of  our  osteopaths  went  out  into  a  new  field  in  the  early  days, 
and,  being  socially  inclined  and  a  good  dancer,  attended  a 
social  function,  at  which  two  of  the  old  school  physicians 
were  present.  Fortunately,  or  unfortunately,  as  the  case 
may  be,  the  osteopath  was  introduced  to  a  medic,  and  it 

—29— 


30  PRACTICAL  VISIONS 

happened  at  a  psychological  moment,  when  a  great  many 
were  standing  around  and  listening.  When  the  introduc- 
tion took  place,  the  medic  did  not  know  that  the  person 
to  whom  he  was  being  introduced  was  an  osteopath,  and 
when  the  osteopath's  name  was  mentioned,  as  being  an 
osteopath,  the  medic  straightened  up,  cleared  his  throat, 
and  said:  "I  meet  you  as  a  gentleman,  but  not  as  a  physi- 
cian." The  osteopath,  being  a  quick-witted  fellow,  re- 
plied immediately,  "Dr.  Small,  I  meet  you  as  a  physician, 
but  not  as  a  gentleman."  I  have  never  forgotten  that 
little  episode,  and  they  say  that  it  caused  consternation  on 
the  floor,  but  that  afterward,  when  the  two  met,  they  were 
quite  good  friends. 

Now,  osteopathy  is  so  well  known  that  it  is  not  referred 
to  in  the  same  manner  as  it  was  in  early  days,  before  it 
was  known  to  have  the  merit  that  it  really  possesses.  Yet 
even  last  week  we  were  treating  a  young  girl,  who  is  engaged 
to  a  druggist.  She  had  torticollis — acute  stage — and  with 
a  specific  adjustment,  lasting  not  more  than  two  minutes, 
we  were  able  to  give  her  immediate  relief.  When  she 
reached  home,  some  one  asked  her  regarding  her  neck  and 
how  she  got  rid  of  her  stiff  muscle  condition  so  readily.  She 
replied  that  she  had  just  been  to  the  osteopath.  The  friend 
asked,  "Have  you  gone  crazy  too?" 

So,  we  see,  even  at  the  present  time,  some  people  refer 
to  osteopathy  as  not  being  quite  right,  but  my  point  of 
contention  is  this:  any  man  doing  honest  work  can  make 
himself  of  such  service  to  the  community  that  eventually 
he  will  be  honored  by  so  doing,  and  people  will  come  to  re- 
spect him  for  his  work  and  the  science  he  represents.  We 
should  be  reasonable  enough  not  to  be  offended  by  ill-con- 
sidered remarks  on  the  part  of  those  not  acquainted  with 
our  work.  Forge  ahead;  relieve  suffering  humanity;  carry 


HONORING  YOUR  PROFESSION  31 

on  free  clinics;  and  make  the  people  realize  the  real  worth 
of  osteopathy.  If  every  osteopathic  physician  will  do  this, 
we  will  eventually  have  the  respect  of  all  people. 

Why  should  not  any  man  feel  that  he  is  doing  noble 
work  when  he  is  straightening  the  spines  of  children,  re- 
storing withered  extremities,  taking  away  headaches,  St. 
Vitus'  Dance,  and  all  forms  of  ailments  that  children  have? 
Likewise,  why  should  any  one  ever  feel  as  if  he  were  not  fol- 
lowing a  noble  science  when  he  is  bringing  back  to  health 
those  who  have  been  given  up  by  physicians  of  the  older 
school;  when  each  year  in  our  practice  we  prevent  a  great 
number  of  surgical  operations  and  relieve  people  from  suffer- 
ing, who  have  had  chronic  ailments  for  many  years? 

Dr.  A.  T.  Still  was  one  of  the  most  persecuted  and  ridi- 
culed men  that  has  ever  lived,  pointed  to  with  a  finger  of 
scorn,  indicating  softening  of  the  cerebral  tissue;  but  he 
had  a  great  purpose.  He  had  a  vision  to  carry  out  and 
materialize,  and  he  knew  that  in  time  the  entire  world  would 
refer  to  osteopathy  as  being  the  most  natural  method  of 
restoration  known  in  the  therapeutic  world. 

The  whole  world  loves  a  good  sport.  It  also  likes  a 
man  who  will  fight  for  right  to  the  last  ditch. 

A  man  can  make  himself  great  in  any  position.  We 
have  noble  examples  of  men  who  have  honored  the  places 
they  occupy,  so  to  speak,  and  apparently  they  are  kings  in 
their  own  domains.  I  have  known  of  newsboys  who  had 
built  up  such  tremendous  patronage,  and  had  conducted 
their  business  so  successfully  and  on  such  honest  lines,  that 
they  were  highly  respected  as  real  business  men  in  their 
own  cities.  We  have  one  in  Toronto.  I  knew  of  one  in 
Denver,  who  has  become  quite  well-to-do.  I  remember 
well  years  ago  when  he  stood  on  a  certain  corner,  and  al- 
though in  that  city  for  recuperative  purposes,  he  overcame 


32  PRACTICAL  VISIONS 

all  obstacles  and  made  himself  so  honored  and  respected 
that  I  have  known  business  men  to  go  two  blocks  out  of 
their  way  just  to  buy  a  paper  from  him  or  to  speak  to  him. 

How  any  osteopath  could  ever  leave  his  work  because 
he  felt  that  some  people  did  not  consider  him  as  "regular" 
as  the  old  school  physician,  I  never  could  understand.  If 
such  an  osteopath  would  have  his  mind  more  on  research 
work  and  the  delving  into  subjects  that  he  might  investi- 
gate, along  anatomical  and  physiological  lines,  he  would 
certainly  have  no  chance  to  reflect  upon  the  trite  or  small 
sayings  of  some  one  who,  either  in  a  jocular  or  cynical  man- 
ner,  attempted  to  ridicule  or  belittle  a  science  that  will  last 
through  all  the  ages. 

There  is  no  field  more  fascinating  than  that  of  thera- 
peutics. There  are  no  books  more  interesting  than  those 
found  on  the  shelves  of  a  medical  library.  Any  physiology 
is  more  interesting  than  the  best  novel;  and  books  on  symp- 
tomatology and  diagnosis  are  more  readily  appreciated  by  a 
true  student  than  the  best  stories  by  the  greatest  of  de- 
tectives. After  all,  a  physician  should  be  a  detective,  al- 
ways on  the  alert  for  signs,  symptoms  and  tracings.  By 
auscultation,  one  can  probe  into  the  mysteries  of  the  hu- 
man body  and  not  only  determine  the  present  status,  but 
can,  through  the  "process  of  deduction,"  almost  read  the 
life  history  of  his  patient.  By  going  over  the  spinal  col- 
umn, the  well-posted  osteopath  can  tell  you  almost  the  year 
in  which  a  certain  accident  happened,  and  almost  the  man- 
ner in  which  his  patient  was  twisted  or  thrown  in  order  to 
produce  the  certain  lesion  that  has  registered  itself  upon  the 
spinal  column.  From  facial  lineations,  it  is  very  easy  for  a 
physician  to  tell  almost  with  accuracy  the  peculiar  organic 
disturbances  found  within  his  patient's  body;  and  from  the 
nature  of  the  headaches,  according  to  the  different  areas  of 


HONORING  YOUR  PROFESSION  33 

the  head,  it  is  quite  possible  in  the  majority  of  instances,  to 
state  whether  the  headache  is  from  stomach  trouble,  or  pel- 
vic organic  disturbances. 

The  study  of  the  reflexes  alone  could  easily  absorb  ten 
years  in  any  osteopath's  life,  and  the  careful  study  of  any 
organ  will  take  another  ten  years,  and,  in  some  instances,  a 
lifetime. 

As  osteopaths,  we  have  access  to  all  books  published  in 
the  world.  We  have  an  opportunity  to  do  research  work 
to  the  fullest  extent.  We  must  never  imagine  that  every- 
thing has  been  learned  in  the  way  of  diagnosis,  or  treatment, 
or  that  the  last  word  in  technic  has  been  given.  Until  we 
have  solved  all  physiological  and  pathological  problems  con- 
cerning normality  and  perversion,  we  should  not  cease  our 
tireless  toil,  amid  inspiring  surroundings,  which  accompany 
eager  students  trying  to  solve  the  mysteries  of  the  human 
body  created  by  the  Great  Physician,  who  alone  knows  the 
significance  of  cells,  tissues  and  systemic  disturbances. 

There  are  so  many  phases  in  the  therapeutic  world,  in 
which  students,  as  all  practitioners  should  be,  can  delve 
into  the  mysteries  regarding  secretions,  circulatory  dis- 
turbances, nerve  instability,  hereditary  diatheses,  along 
with  idiosyncrasies,  and  central  lesion  manifestations,  that 
we  have  simply  to  select  some  one  line  of  work,  and  follow 
up  logically,  reasonings  that  will  lead  to  better  diagnoses, 
technic,  and  treatment. 


(3) 


CHAPTER  IV 


THE  FRESHMAN 


CHAPTER  IV. 

THE  FRESHMAN 

Let  us  again  live  over  our  college  days  and  see  if  we 
can  point  out  wherein  we  could  have  made  more  progress  in 
our  studies,  and  accomplished  more  in  the  way  of  connect- 
ing up  the  various  subjects  with  a  consideration  of  the  body 
as  a  machine,  and  as  a  whole. 

The  tendency  in  the  first  year  at  college  is  to  get  a  cir- 
cumscribed idea  of  the  tissues,  and  neglect,  in  a  way,  the 
broader  vision  that  a  student  really  should  have  in  order 
that  he  may  accomplish  the  greatest  amount  of  work. 

We  admit  that  it  is  essential  to  use  the  microscope  in 
histology,  biology,  and  so  forth,  and  that  a  student  must 
secure  a  definite  idea  of  the  basic  principles  of  therapeutics, 
and  that  the  study  of  cell  lif e  is  an  essential  feature  for  a 
clear  understanding  of  the  body  as  a  whole. 

In  looking  back  through  the  long  years,  after  one  has 
been  in  practice,  the  subjects  in  the  first  year's  course  seem 
so  easy  and  few  in  number,  It  seems  as  if  the  student 
should  grasp  the  entire  year's  course  in  two  or  three  months' 
time;  but  we  must  remember  that  the  studies  are  new,  and 
that  possibly  the  student  is  working  along  entirely  different 
lines  from  what  he  anticipated  when  he  was  going  through 
high  school,  and,  possibly,  college. 

The  subject  that  appeals  most  to  the  majority  of  stu- 
dents is  anatomy.  The  jonah  of  all  subjects,  in  the  majority 
of  instances,  is  chemistry.  Lucky  is  the  young  man  who 
has  a  liking  for  chemistry,  and  who  has  had  particular  coach- 
ing along  that  line.  It  will  lighten  his  burdens  all  through 
the  four  year  course,  and,  after  all,  chemistry  possibly  is 
the  most  important  of  all  subjects  in  any  course  that  a  stu- 

—37— 


38  PRACTICAL  VISIONS 

dent  may  follow.  It  is  necessary  to  have  a  good  knowledge 
of  chemistry  in  almost  every  line  of  work  today.  Especially 
is  it  most  essential  for  a  student  of  the  human  body,  who  in- 
tends to  practice  the  therapeutic  art,  to  know  in  detail 
physiological  chemistry  in  order  that  he  may  apply  his  gen- 
eral  knowledge  to  specific  cases  to  the  end  that  his  know- 
ledge of  chemistry  will  be  of  the  greatest  value  to  him  in 
handling  his  patients 

There  is  something  fascinating  about  histology.  The 
use  of  the  microscope,  acquainting  oneself  with  the  various 
forms  of  cells  and  tissues,  makes  the  subject  anything  but 
monotonous  from  day  to  day.  It  is  not  like  the  bricks  in  a 
house.  Although  they  are  the  units,  and  the  assembling 
of  the  same  make  up  the  whole,  yet  there  is  a  sameness  to 
the  bricks  and  their  composition  is  identical.  The  fasci- 
nating thing  about  histology  is  that  each  organ  has  its  own 
peculiar  function.  The  position  of  the  cells  and  arrange- 
ment of  the  tissues  in  a  state  of  health  is  such,  that,  there 
is  a  harmonious  action  of  parts  composing  the  various 
organs,  or  producing  the  various  secretions  and  activities  of 
each  cell  and  tissue. 

After  familiarizing  oneself  with  the  various  cells  in  the 
human  body,  and  their  arrangement  in  the  organs  and  tis- 
sues, the  study  of  physiology  is  equally  fascinating,  in  that 
we  determine  the  relative  activities  of  the  various  organs  in 
the  systemic  functioning  of  the  human  machine. 

Few  students  are  capable  of  making  drawings  sufficient- 
ly accurate  to  enable  them  to  derive  benefit  from  their 
rough  sketches  day  after  day.  However,  there  are  a  few 
students  who  could,  with  a  little  practice,  acquaint  them- 
selves with  the  art  of  drawing  sufficiently  well  to  enable 
them  to  grasp  more  in  detail  the  relation  of  the  cells  to  the 
tissues,  and  the  tissues  to  the  body  as  a  whole,  and  thereby 


THE  FRESHMAN  39 

work  out  the  relationships  from  time  to  time  and  more 
readily  understand  them  through  these  object  lessons. 

We  have  stated  at  various  times  that  it  is  only  a  mat- 
ter of  time  until  there  will  be  histologies  written  from  a 
different  viewpoint,  in  that  the  student  will  be  able  to  grasp 
from  drawings  and  charts  the  systematic  arrangement  of 
the  various  cells  and  tissues  throughout  the  body  almost  at 
a  glance.  It  is  quite  impossible  now  for  a  student  to  get 
his  bearings  and  so  arrange  in  his  mind  a  mental  picture  of 
the  various  cells  and  tissues  that  he  will  be  able,  after  finish- 
ing his  course  in  histology,  to  state  exactly  the  relative  pro- 
portions of  the  different  varieties  of  cells  and  tissues  in  the 
general  make-up  of  the  human  machine. 

We  hope  at  some  future  date  to  illustrate  a  book  on 
histology  that  will  make  the  study  a  pleasure  to  any  and 
all  students. 

Accompanying  every  illustration  that  is  found  in  his- 
tologies at  the  present  time,  there  should  be  a  large  chart 
showing  the  amount  of  cells  and  tissues  of  a  certain  nature, 
in  proportion  to  that  of  the  entire  body.  There  should  be 
drawings  and  charts  also  illustrating  the  various  histological 
specimens  in  their  relation  to  adjacent  tissues;  also,  the 
general  vascularization  and  innervation.  This  has  been 
sadly  neglected,  and  the  student  only  comprehends  these 
points  after  he  has  well  passed  through  the  major  part  of 
his  college  course. 

The  study  of  anatomy,  as  we  have  stated,  is  the  most 
fascinating.  The  text 'books  on  the  subject  seem  large;  the 
words  are  long  and  hard;  their  terminology  is  sometimes 
difficult  to  comprehend.  It  calls  for  a  previous  training 
in  Latin  and  Greek.  The  majority  of  the  words  were  "coin- 
ed, "  as  we  say  today,  by  the  ancients.  Under  varying  cir- 
cumstances, each  point  of  interest  on  the  bones  was  named, 


40  PRACTICAL  VISIONS 

either  after  some  physician  in  the  ancient  order,  or  accord- 
ing to  the  peculiar  resemblance  to  some  object  other  than 
found  in  the  human  anatomy.  Only  in  a  few  instances 
were  these  original  word  "coiners"  unable  to  give  the  par- 
ticular part  under  discussion  a  name.  In  these  instances  we 
find  the  word  "innominate."  This  word,  however,  is  pos- 
sibly as  significant  as  some  of  the  terms  that  are  applied 
to  the  various  organs  and  tissues  in  different  parts  of  the 
body. 

We  found  one  way  of  handling  the  new-word  proposi- 
tion most  satisfactorily.  Were  we  to  go  through  college 
again,  we  would  follow  the  same  course. 

Securing  a  two  hundred  page,  indexed,  blank  book, 
well-bound  in  cloth,  write  down  every  new  word  in  anatomy 
that  you  come  across,  right  from  the  first  day  of  college. 
After  each  word,  derivation  and  significance.  The  mere 
fact  of  making  out  a  dictionary  of  your  own  is  of  more  value 
than  you  can  possibly  imagine. 

Next  secure  a  box  of  colored  crayons,  or  pencils,  and  a 
dozen  rough,  scratch  tablets,  and  continuously  design  the 
relationship  of  the  various  organs  and  tissues  as  you  pursue 
your  course  of  instruction  in  anatomy. 

If  you  can  put  on  paper  the  relationship  of  the  various 
organs  and  tissues,  you  will  have  an  object  lesson  that  will 
imprint  itself  so  readily  upon  your  mind  that  you  will  al- 
ways have  a  much  better  conception  of  the  part  that  you 
have  designed  on  paper. 

Some  day  also  there  will  be  anatomies  published  that 
will  be  so  far  ahead  of  the  anatomies  that  are  printed  at  the 
present  time  that  we  will  look  back  to  these  in  wonderment 
and  try  to  determine  why  the  various  parts  of  the  body 
were  not  put  up  in  a  manner  that  would  have  been  more 
readily  comprehended  by  the  students  in  the  schools. 


THE  FRESHMAN  41 

We  will  not  give,  at  this  point,  our  ideas  regarding  the 
illustrating  of  an  anatomy,  but  trust  some  day  that  we  may 
work  out  in  detail,  drawings  that  will  make  the  subject  much 
more  comprehensible  to  the  student  body. 

After  the  first  few  months,  the  freshman  begins  to  think 
that  he  has  the  subject  of  anatomy  pretty  well  in  hand.  He 
has  possibly  covered  certain  sections,  or  regions,  and  his 
idea  is  that  if  he  can  cover  the  rest  of  the  body,  he  will  then 
know  the  subject  very  well  indeed.  We  will  not  try  in  any 
way  to  discourage  the  students,  as  the  subject  of  anatomy 
is  fascinating,  and  it  is  possible  for  the  earnest  student  to 
comprehend  anatomy  to  a  great  extent;  but  keep  in  mind 
that  in  the  first  term,  when  you  are  going  over  the  various 
sections,  one  by  one,  you  must  some  day  put  them  all  to- 
gether and  so  familiarize  yourself  with  the  human  anatomy 
that  you  can  visualize  the  entirety  of  the  body  mechanism, 
especially  in  reference  to  the  vascularization  and  innerva- 
tion  of  all  parts  of  the  body. 

If  you  are  adapted  along  the  line  of  drawing,  try  and 
make  enlarged  pictures,  either  from  your  texts,  or  from 
your  biology  studies,  and  you  will  be  surprised  at  how 
pleasing  the  results  will  be.  You  will  feel  that  you  have  a 
better  understanding  of  the  human  organism,  both  as  to 
its  localized  relationship  and  from  a  systemic  standpoint. 

Physiology  is  one  of  the  most  fascinating  of  all  the 
subjects.  It  will  pay  any  student  to  follow  very  closely  the 
first  chapters  in  any  book  on  physiology.  The  fundamentals 
of  the  subject  become  the  basic  principles  of  all  functioning 
processes  in  their  relation  to  the  systemic  functioning  that 
will  be  considered  when  one  enters  the  field  of  practice. 

It  is  well,  also,  to  buy  a  blank,  bound,  volume  of  good 
paper,  and  make  drawings  from  time  to  tune,  illustrating 
every  point  that  is  brought  out  throughout  the  book.  If 


42  PRACTICAL  VISIONS 

you  do  this,  you  will  find  that  at  the  close  of  the  term  you 
will  have  a  basic  understanding  of  physiological  function- 
ings  that  will  be  of  great  value  to  you,  in  that  you  have 
made  objective  impressions  upon  your  mind,  through  the 
various  drawings  in  colors  that  you  have  made  from  time 
to  time. 

The  subject  of  embryology  is  not  always  so  fascinating, 
and  yet  of  vital  importance,  in  that  even  after  you  are  prac- 
ticing in  the  field  you  will  find  that  in  discussing  organic  dis- 
turbances you  will  constantly  be  referring  back  to  the  em- 
bryological  phases,  and  you  will  draw  some  of  your  finest 
conclusions  from  your  logical,  embryological  reasonings. 

It  is  almost  impossible  to  be  a  good  anatomist,  or  well 
posted  in  physiology,  without  absolutely  knowing  in  detail 
your  embryology.  The  peculiar  arrangement  of  the  cells, 
tissues  and  organs  of  the  body  as  a  rule  date  back  to  the 
embryological  period  when  the  formation  of  the  cells  and 
tissues  were  such  that,  in  some  instances,  anomolies  were 
produced.  In  other  instances,  growths,  possibly  malig- 
nant, eventually  may  result  from  a  disturbance  in  the  em- 
bryological period.  Possibly  an  existing  hereditary  dia- 
thesis may  produce  in  time  a  phase  that  comes  to  be  patho- 
logical in  its  significance,  and  can  only  be  comprehended 
from  an  embryological  standpoint. 

Undoubtedly  observations  on  the  part  of  an  expectant 
mother  may  disturb  the  unborn  to  the  extent  that  the, 
mere  visualization  resulting  from  an  abnormal  experience 
either  physical  or  psychological,  may  disturb  the  relationship 
of  the  normal  cells  so  that  eventually,  almost  any  known 
disease  may  result. 

The  first  term  may  seem  the  hardest  to  the  new  stu- 
dent; but,  in  a  great  many  ways,  the  reasonings  from  a 
logical  and  analytical  standpoint  during  the  freshman  year 
either  make  or  fail  to  make  the  true  physician  in  the  end. 


CHAPTER  V 


THE  SOPHOMORE 


CHAPTER  V. 

THE  SOPHOMORE 

It  is  with  a  great  sigh  of  relief  that  the  freshman  enters 
his  second  year.  There  is  something  about  being  a  fresh- 
man that  makes  one  feel  as  if  he  were  nothing  at  all.  How- 
ever, before  any  structure  can  be  built,  there  must  be  a 
foundation,  and  wise  is  the  student  who  builds  that  founda- 
tion well,  and  builds  doubly  strong,  in  case  that  the  struc- 
ture he  rears  during  the  four  years'  course  will  have  stimu- 
lated him  sufficiently  to  add  on  a  few  stories  later. 

It  is  the  superstructure,  built  by  conscientious  research 
work,  that  makes  one  doctor  more  prominent  than  another. 
We  often  hear  it  said,  "Well,  that  Dr.  So-and-So  was  a 
classmate  of  mine.  We  studied  the  same  length  of  time, 
had  the  same  teachers  and  used  the  same  books.  I  do  not 
see  how  he  is  any  greater  than  I  am. "  That  is  the  wrong 
idea  entirely.  The  viewpoint  a  freshman  gets  is  often  the 
one  that  will  make  his  fame  world-wide,  when  the  man 
standing  beside  him  in  the  laboratory,  and  sitting  beside 
him  in  the  class-room,  will  remain  just  about  at  the  same 
point  all  through  the  years  as  where  he  left  off  when  he 
finished  his  course  and  received  his  degree. 

There  are  physicians  and  surgeons  who  are  sufficiently 
well-known  in  this  country  to  attract  to  their  clinics  other 
surgeons  from  all  the  countries  in  the  world,  and  these  same 
leading  surgeons  went  through  the  same  colleges,  with  the 
same  post  graduate  courses,  as  a  great  many  others  who  are 
never  heard  of. 

If  a  man  devotes  his  entire  time  and  energy  to  his  work, 
puts  his  whole  soul  into  it  and  has  a  reasonable  amount  of 


46  PRACTICAL  VISIONS 

cerebral  matter,  there  is  no  reason  why  he  should  not  excel 
in  his  work.  If  he  becomes  disinterested  and  does  not 
follow  up  his  studies,  he  passes  into  class  "B"  or  "C," 
and  the  world  does  not  hear  of  him.  Be  a  class  "A"  man, 
and  never  stop  dreaming  and  developing  the  ideas  and  out- 
lines that  are  given  to  you  from  time  to  time.  No  man 
goes  through  life  without  a  vision.  No  man  lives  who  has 
not  had  dreams  and  been  given  ideas  that,  if  carried  out, 
would  make  him  known  the  world  over. 

The  second  year's  work  naturally  includes  more  sub- 
jects than  are  taught  in  the  first  year,  and  while  part  of  the 
same  ground  is  covered  in  a  more  practical  manner,  yet  the 
greater  variety  of  subjects  adds  particular  interest  to  the 
student  who  is  desirous  of  having  a  broader  knowledge  of 
the  fundamental  principles  of  therapeutics.  In  fact,  it 
takes  about  the  first  year's  work  to  get  the  viewpoint 
and  to  realize  just  about  what  is  meant  by  "  considering  the 
body  as  a  whole,"  and  learning  to  classify,  co-ordinate,  and 
clarify  the  various  subjects. 

It  is  quite  natural  for  a  student  in  medicine  to  want  to 
learn,  as  early  as  possible,  how  to  write  a  prescription.  It 
is  equally  fascinating  for  a  student  in  osteopathy  to  be 
able  to  give  his  first  treatment.  This  anxiety  upon  the  part 
of  the  student  is  sometimes  detrimental,  in  that  it  is  quite 
necessary  to  understand  the  basic  principles  of  a  science 
before  being  able  accurately  to  apply  that  science  when  the 
proper  time  comes. 

Pathology,  as  taught  in  the  second  year,  is  possibly 
one  of  the  most  important  subjects  that  a  young  physician 
may  be  instructed  in.  It  is  absolutely  essential  to  know 
your  pathology  in  detail,  if  you  expect  to  make  proper  diag- 
noses from  subjective  and  objective  symptoms.  If  a  physi- 
cian follows  closely  his  pathology  text,  providing  it  is  cor- 


THE  SOPHOMORE  47 

rectly  written,  and  viewed  from  a  standpoint  that  consid- 
ers the  lesion  as  the  factor  in  determining  function  or  loss  of 
the  same,  the  proper  application  of  this  subject  will  enable 
him  more  accurately  to  understand  and  diagnose  his  pa- 
tient's ailment. 

The  second  year  is  too  early  a  time  to  consider  diag- 
nosis or  even  symptomatology,  other  than  an  occasional 
reference  on  the  part  of  the  teacher. 

The  first  and  second  years  are  really  the  foundation 
work  and  upon  these  two  years,  the  third  and  fourth  years' 
structure  is  built. 

Applied  anatomy  begins  to  be  woven  into  the  general 
scheme  of  considering  body  structure,  and  well  it  may  be, 
as  no  subject  taught  in  the  four  years'  course  is  of  more 
practical  value  than  that  of  applied  anatomy. 

There  are  a  number  of  text  books  on  this  subject,  and 
we  are  yet  to  have  more  texts  written  on  applied  anatomy  by 
some  of  our  osteopathic  physicians. 

The  dissecting  room  has  a  fascination  for  a  few,  but 
is  rather  objectionable  to  a  great  many;  but  for  the  real  stu- 
dent and  prospective  research  worker  the  dissection  room 
means  but  an  advancement  to  a  more  thorough  understand- 
ing of  the  human  body  and  the  mechanical  phase  which  is 
so  important  to  a  physician. 

No  man  can  become  a  weU-rounded  physician  without 
being  familiar  with  all  of  the  tissues  and  the  arrangement  of 
the  organs  in  the  various  regions  of  the  human  machine; 
and  a  thorough  comprehension  of  the  body  mechanism,  as 
demonstrated  in  the  dissecting  room,  leads  the  true  stu- 
dent to  a  line  of  reasoning  that  will  possibly  never  end,  in 
that  he  has  a  desire  to  conduct  postmortems  later  on  and 
verify,  or  be  able  to  contradict,  statements  made  regarding 
diagnosis  in  antemortem  days. 


48  PRACTICAL  VISIONS 

A  real  expert,  working  in  any  machine  shop,  or  going 
over  a  machine  that  has  once  been  built  and  perfected, 
must  needs  know  every  part  of  that  machine,  and  not  only 
its  workings,  but  the  peculiar  sounds  that  are  connected 
with  the  machine  when  in  motion. 

We,  likewise,  become  familiar  with  the  human  body 
when  diagnosing,  by  recognizing  certain  sounds  through 
auscultation,  palpation,  and  so  forth,  that  connect  up  and 
refer  back  to  the  days  we  spent  in  the  dissecting  room,  figur- 
ing out  not  only  the  arrangement  of  the  organs,  but  their 
relationship  to  the  various  structures  in  the  various  cavities. 

The  study  of  neurology  interests  almost  every  student. 
It  is  absolutely  essential  to  familiarize  yourself  with  this 
particular  branch,  in  order  that  you  may  more  thoroughly 
understand  what  are  referred  to  as  impulses,  in  particular, 
and  the  effect  upon  the  human  mechanism  through  nerve 
instability,  reflected,  possibly,  by  a  diseased  organ,  or  cer- 
tain tissues  that  are  abnormal. 

It  is  not  always  possible  for  a  teacher  instructing  day 
by  day  to  determine  just  which  students  are  most  likely  to 
become  the  best  practitioners  when  they  enter  the  field; 
but,  as  a  rule,  the  professor  can  tell  by  the  interest  shown, 
and  by  the  questions  asked,  just  which  students  are  the 
most  promising.  However,  there  are  a  great  many  surprises 
in  every  school,  and  it  often  happens  that  the  student  of 
whom  you  expect  least  turns  out  to  be  the  best  known  man. 
Sometimes  the  dreamy  sort  of  chap,  who  apparently  is  not 
listening  to  what  the  instructor  is  saying,  and  who  does  not 
always  answer  with  the  greatest  rapidity  the  questions  fired 
at  him,  will  turn  out  to  be  not  only  a  successful  practitioner, 
but  a  research  worker.  The  peculiar  formation  of  the  hu- 
man mind  is  such  that  a  certain  turn  of  the  mind,  so  to 
speak,  will  bring  out  ideas  not  conceived  of  by  other  men. 


THE  SOPHOMORE  49 

The  mind  is  so  complex  in  its  workings  that  should  a  stu- 
dent be  inclined  toward  an  inventive  nature,  and  yet  be 
studying  therapeutics,  he  will,  in  all  probability,  be  the  very 
one  who  will  give  to  the  world  new  ideas  regarding  the 
functioning  of  various  organs,  or  possibly  something  deal- 
ing with  the  chemistry  of  the  body  that  has  never  been 
worked  out  before. 

As  a  rule,  students  in  the  second  year  are  very  anxious 
to  do  a  little  treating.  They  think  that  "practice  makes 
perfect,"  and  that  they  should  begin  to  manipulate  or  to 
adjust  certain  osseous  tissues;  and  they  are  very  apt  to  take 
instruction,  on  the  side,  from  seniors,  or  possibly,  juniors. 
It  is  better,  as  a  rule,  to  follow  the  instruction  of  the  pro- 
fessors, and  not  hasten  into  corrective  measures  until  the 
instructor  is  satisfied  that  the  student  is  sufficiently  ground- 
ed in  the  basic  principles  of  therapeutics  to  enable  him  to 
comprehend  and  apply  with  accuracy,  such  technic  as  will 
be  described  from  time  to  time. 

If  I  were  to  measure  the  value  of  a  student,  I  believe  it 
would  be  along  the  line  of  determining  how  keenly  inter- 
ested that  student  is  regarding  applied  anatomy.  This 
would  also  include  applied  physiology,  if  there  be  such  a 
thing. 

At  this  particular  stage  in  the  college  course,  we  usually 
find  some  of  the  students  putting  two  and  two  together  and 
wondering  just  how  many  nerves  there  are  in  the  human 
body;  how  many  reflexes,  and  if  it  is  possible  to  determine 
new  reflexes;  also,  whether  they  will  discover  in  pathology 
some  new  phase,  or  possibly,  in  some  way,  discover  a  new 
symptom  or  disease,  and,  by  making  the  proper  applica- 
tion, demonstrate  at  a  later  date  some  technic  that  will 
reach,  through  specific  nerve  centers,  certain  ailments  that 
have  practically  been  neglected  in  previous  years. 

(4) 


50  PRACTICAL  VISIONS 

All  sorts  of  ideas  go  through  the  student's  mind,  and, 
straLge  to  say,  very  few  carry  out,  in  after  life  the  dreams 
or  wishes  they  formulated  when  in  the  second  year. 

During  the  first  year,  everything  was  from  an  imaginary 
standpoint,  as  they  had  only  basic  principles  or  knowledge 
regarding  anatomy,  physiology,  and  so  forth;  but,  in  the 
second  year,  after  having  gone  through  all  of  the  elementary 
subjects,  you  will  find  the  students  reasoning  along  a  differ- 
ent line,  and  stating  that  some  day  they  will  do  so  and  so, 
and  that,  in  future  years,  they  will,  when  they  have  time, 
write  texts  on  certain  subjects,  or  make  a  series  of  dissec- 
tions that  will  prove  so  and  so.  All  of  this  outline  work, 
even  though  imaginary,  to  some  extent,  is  of  value  to  the 
student,  and  if  he  has  sufficient  will  power  and  determina- 
tion, he  will  work  out  some  therapeutic  truths  and  visualize 
to  the  extent  that  he  will  be  of  benefit  to  his  fellow  prac- 
titioners. 

During  the  second  year,  the  study  of  physiology  will 
have  become  so  fascinating  that  the  autonomic  system  will 
begin  to  reveal  itself,  and  the  student  will  realize  what  the 
vasomotors  mean,  and  what  certain  nerve  centers  signify, 
relative  to  the  stimulation  of  the  vasomotors  controlling 
the  blood  vessels  throughout  the  body.  He  will  also  realize 
that  the  circulation  to  the  head,  for  instance,  is  regulated 
by  nerve  centers  in  the  region  of  the  upper  thoracic;  and 
that  the  impulses  must  pass  through  preganglionic  fibers 
traversing  the  first  thoracic  ganglion,  the  lower,  middle,  and 
finally,  the  superior  cervical  ganglion,  where  postganglionic 
fibers  are  given  off  to  control  the  vessels  in  the  head.  He 
will  realize  that  this  arrangement  is  quite  different  from  that 
found  in  the  control  of  the  mesenteric  vessels  by  the  splanch- 
nic nerves,  and  that  the  postganglionic  arrangement  in  this 
area  is  quite  different  from  that  in  the  regulation  of  the 


THE  SOPHOMORE  51 

blood  cephalad,  as  the  preganglionic  fibers  are  more  or  less 
continuous  in  their  arrangement  until  a  portion  of  the  semi- 
lunar  ganglion  is  reached,  where  the  postganglionic  fibers 
are  given  off  to  control  the  mesenteric  vessels  in  the  abdom- 
inal area. 

He  will  also  have  found  out  that  the  spinal  cord  does 
not  extend  down  the  full  length  of  the  spine,  and  the  reason 
for  this  peculiar  arrangement  will  have  been  explained  by 
the  professor.  He  will  also  appreciate  the  fact  that  in 
order  to  control  the  blood  vessels  in  the  lower  extremities 
he  must  consider  specific  nerve  centers  in  the  region  of  the 
lower  thoracic,  instead  of  the  lower  lumbar  and  sacral  areas, 
although  adjustment  of  the  sacrum  and  innominates  may  be 
necessary  in  order  to  stabilize  the  spine  and  secure  nerve 
tone  sufficiently  to  re-establish  the  circulation  in  the  feet. 

Special  instruction  regarding  osteopathic  principles 
will  have  been  given  in  the  second  year  to  enable  the  stu- 
dent to  realize  the  osteopathic  concept,  as  taught  by  Dr. 
A.  T.  Still,  who  worked  out  in  detail  the  practice  of  oste- 
opathy, after  having  made,  possibly,  more  dissections  and 
having  studied  human  anatomy  more  carefully  than  any 
student  that  will  ever  go  through  an  osteopathic  college. 


CHAPTER  VI 


THE  JUNIOR 


CHAPTER  VI. 

THE  JUNIOR 

The  keen  and  appreciative  student  at  any  college  of 
osteopathy,  who  is  not  extremely  handicapped  from  a  finan- 
cial standpoint,  will  associate  himself  with  some  practicing 
physician  during  the  summer  months.  He  may  not  re- 
ceive any  compensation  for  his  services,  but  there  are  those 
practicing  in  the  field  who  are  perfectly  willing  to  allow  a 
student  half  way  through  college,  to  visit  their  offices,  make 
observations,  and  possibly  talk  with  them  for  an  hour  each 
day  or  evening.  It  should  be  a  pleasure  for  any  practitioner 
to  extend  this  courtesy  to  a  student,  and  if  the  student  is 
sufficiently  insistent,  and  yet  ethical,  he  will  have  no  diffi- 
culty in  associating  himself,  during  the  summer  months,  with 
some  practitioner. 

Well  do  I  remember  the  summer  months  spent  under 
one  of  the  older  graduates,  out  in  the  state  of  Iowa.  Case 
after  case  came  under  my  observation.  The  doctor  was  very 
kind,  indeed,  to  me.  She  had  two  offices,  and  allowed  me 
to  take  charge  of  one  of  them,  which  made  me  feel  that  I 
was  at  least  a  doctor  in  the  making.  The  result  was  that 
after  the  summer's  experience  I  returned  to  Kirksville  with  a 
new  vision,  a  new  conception,  and  a  greater  determination 
to  accomplish  more  in  the  last  terms  than  ever  before.  Need- 
less to  say,  I  was  in  a  better  position  to  ask  more  intelligent 
questions  of  the  various  professors.  The  result  was  that  the 
last  year  was  of  double  value  to  me,  and  when  I  was  grad- 
uated I  felt  as  if  I  could  go  right  out,  take  hold  of  a  practice, 
(which  I  did)  and  make  good.  It  gave  me  confidence  and 
an  insight  into  the  way  in  which  cases  are  handled  in  the 
field.  By  the  way,  there  is  quite  a  difference  in  these  two 

—55— 


56  PRACTICAL  VISIONS 

propositions,  as  we  will  discuss  in  the  chapter  on  "Opening 
an  Office." 

We  want  here  to  give  the  student,  who  is  now  a  junior, 
and  referred  to  as  "Doctor"  by  some  of  his  classmates,  an 
insight  into  the  practical  viewpoint  on  various  subjects. 
We  must  admit  that  in  all  schools  and  colleges  certain  sub- 
jects are  included  for  mental  development  alone.  They  have 
no  particular  practical  side,  other  than  developing  in  the 
mind  greater  reasoning  powers.  There  are  other  subjects 
of  most  vital  interest,  and  on  which  we  do  not  receive  suffi- 
cient instruction.  This  is  no  reflection  upon  the  teachers. 
It  is  quite  impossible  in  a  school  calendar  to  arrange  sub- 
jects so  that  one  subject  will  have  precedence,  or  apparently 
greater  value,  over  another  subject.  It  is  only  after  we  have 
been  handling  cases  in  the  field  for  some  years  that  we  can 
tell  just  what  particular  part  of  the  course  is  of  the  greatest 
value  to  the  student  who  is  anxious  to  get  out  in  the  field 
and  make  good.  "Making  good"  does  not  necessarily 
mean  accomplishing  great  things  in  the  way  of  having  a 
tremendous  practice.  It  refers  more  to  specific  osteopathy, 
and  the  results  obtained  in  the  shortest  period  of  time.  To 
me,  the  greatest  practitioner  is  the  one  who  can  be  the  most 
specific  and  at  the  same  time  secure  the  best  results.  I 
believe  this  was  the  Old  Doctor's  idea  when  he  made  that 
famous  remark:  "Find  it,  fix  it,  and  leave  it  alone, "  which 
should  be  emblazoned  in  gold  upon  the  mental  vision  of 
every  student  and  practitioner  in  the  world. 

We  will  not  indicate  specifically  what  subjects  are  of 
greatest  import  in  the  course,  for  fear  that  the  students  will 
neglect  other  subjects,  but  we  will  emphasize  certain  phases 
of  certain  subjects,  and  no  one  can  be  blamed  when  inferences 
are  made  by  students. 

There  is  no  doubt  in  the  world  but  that  applied  anatomy 


THE  JUNIOR  57 

is  of  the  greatest  value,  and  we  regret  exceedingly  that 
we  have  not  more  books  on  this  important  subject.  Dr. 
M.  E.  Clark  did  the  osteopathic  world  great  service  when 
he  published  a  book  on  applied  anatomy  years  ago.  It 
should  have  been  revised  every  year  since,  and  the  entire 
edition  should  have  been  sold  out  each  year.  I  like  those 
doctors  who  buy  the  latest  editions  and  do  not  say  that 
because  they  have  a  certain  book  they  don't  need  a  revised 
edition.  Even  anatomies  change,  and  they  are  still  far 
from  perfect.  We  have  noted  errors  in  the  text  and  draw- 
ings of  the  best  known  anatomy  in  the  world.  There  is 
one  illustration  that  is  incorrect  to  which  attention  has 
never  been  called.  A  new  text  on  a  particular  gland  in  the 
body  contains  two  errors  obvious  on  casual  observation, 
and  we  have  not  the  heart  to  write  the  author  referring  to 
these  two  errors,  for  fear  he  will  not  appreciate  it. 

There  will  be  a  splendid  revised  applied  anatomy  one 
of  these  days,  and  I  am  not  so  sure  but  that  there  will  be 
another  applied  anatomy,  unusually  illustrated  and  contain- 
ing about  eleven  hundred  pages,  all  from  an  osteopathic 
standpoint.  There  is  a  certain  doctor  in  our  profession 
who  has  been  working  on  this  for  six  years. 

We  have  suggested  in  other  chapters  that  the  student 
make  certain  sketches  from  time  to  time,  even  though  they 
be  crude.  These  sketches  should  be  made  from  an  applied 
anatomy  standpoint,  and  the  field  in  that  line  is  so  vast 
that  there  is  no  limitation  to  it.  There  is  not  a  single  tissue, 
organ,  or  structure  in  the  human  body  that  cannot  be  re- 
ferred to  from  an  applied  standpoint  in  almost  as  many 
ways  as  the  alphabet  can  be  arranged  into  words  that  make 
up  a  dictionaiy . 

We  often  think  the  last  word  has  been  said  in  anatomy, 
as  well  as  in  therapeutics,  but  we  will  live  to  see  a  day  when 


58  PRACTICAL  VISIONS 

we  will  look  back  to  the  present  as  the  "  kindergarten  age. " 
In  time  we  must  know  the  human  mechanism  from  a  stand- 
point that  will  give  us  a  vision  into  its  workings  such  that  we 
can  "put  two  and  two  together,"  so  to  speak,  and  size  up  a 
person  not  only  by  his  posture,  physiological  spinal  curves, 
unilateral  symmetry,  thermogenic  findings,  vasomotor  in- 
sufficiencies, vascular  irregularities,  and  lymphatic  ede- 
matous  areas,  but  also,  putting  the  various  parts  together, 
we  can  make  a  mental  picture  from  an  applied  anatomy 
viewpoint,  that  will  enable  us  to  see  the  entire  mechanism 
from  a  real  mechanical  standpoint. 

Likewise,  we  take  the  various  subjects  that  are  studied 
in  the  third  year,  and  apply  them  to  the  clinic  room,  and  the 
bedside.  Most  of  all,  we  realize  as  we  study  each  subject 
that  when  faced  by  our  patients  in  the  field,  we  must  have 
sufficient  confidence  in  our  ability  to  read  and  interpret  the 
various  findings,  that  we  will  be  masters  of  the  situation. 

The  subjects  included  in  the  junior  course  are  of  a  na- 
ture that  broadens  the  student  almost  to  the  finishing  point. 
Possibly  some  will  be  more  interested  in  the  specialties,  and 
surgery  will  prove  fascinating  to  a  number.  Eye,  ear,  nose 
and  throat  work  appeals  to  a  great  many,  as  it  is  not  diffi- 
cult, and  the  student  will  feel  that  he  can  work  a  great  deal 
in  his  own  private  office,  surrounded  by  enamel  and  nickel 
ware,  with  a  nurse  in  uniform,  and  everything  in  perfect 
readiness  at  all  times.  There  are  still  others  who  will  feel 
the  call  of  the  Old  Doctor,  and  will  long  to  see  what  they  can 
do  in  the  field  by  straight  osteopathic  manipulation.  After 
all,  osteopathy,  in  the  true  sense,  as  brought  out  by  the  Old 
Doctor,  referred  more  to  general  than  to  special  work.  It 
is  perfectly  all  right  for  those  who  like  specialty  work  to 
drift  oft"  into  those  fields,  and  they  need  not  dissociate  oste- 
opathy from  their  specialty,  but  to  my  mind  those  who  are 


THE  JUNIOR  59 

to  perpetuate  the  great  science  of  osteopathy  are  those  who 
will  go  out  and  enter  into  general  practice.  In  other  words, 
they  will  be  able  to  go  to  the  bedside  of  a  fevered  patient, 
and  by  a  practical  knowledge  of  human  anatomy  and  by 
specifically  applied  treatment,  from  an  osteopathic  stand- 
point, reduce  that  fever  without  even  one  drop  of  medica- 
tion. This  will  bring  out  self-reliance,  confidence,  and  above 
all,  the  accumulated  knowledge  of  the  nervous  mechanism 
from  an  applied  standpoint  that  we  have  referred  to  so  many 
times. 

You  will  also  have  another  test  of  your  ability  as  a 
physician,  when,  by  non-surgical  methods,  you  will  be  able 
to  prevent  operations,  restore  the  human  body  to  normal 
conditions,  re-establish  internal  secretions,  and  straighten 
out  the  muscular  tangles  through  correction  of  osseous 
lesions  that  interfere  so  directly  with  the  great  nerve  forces 
that  radiate  in  all  directions  from  these  various  specific 
points. 

You  will,  likewise,  be  able  to  attend  your  obstetrical 
cases  and,  through  osteopathic  knowledge,  prevent  lacera- 
tions and  puerperal  fevers.  Go  down  to  Indianapolis  and 
watch  that  obstetrical  wizard  who  has,  possibly,  made  more 
deliveries  than  any  other  osteopath  in  the  world,  or  go  out 
to  the  Golden  Gate  Coast  and  watch  that  woman  who  walks 
through  the  wards  in  the  various  hospitals  and  from  an  ab- 
solutely osteopathic  standpoint,  produces  a  smile  on  the 
mother's  face,  instead  of  a  tear  and  line  of  worry. 

"Try  osteopathy  first,"  is  a  motto  I  wish  you  would 
never  get  away  from — and  tell  me  this:  How  can  an  os- 
teopathic physician  develop  self-reliance,  confidence,  and 
natural  resourcefulness  unless  he  is  put  to  at  least  an  oc- 
casional test? 

It  is  the  dependence  upon  a  little  morphia,  sedative, 


60  PRACTICAL  VISIONS 

anodyne,  analgesic,  and  an  occasional  operation,  at  least, 
that  makes  a  physician  feel  so  confident  in  himself,  in  that 
he  has  recourse  to  certain  things  that  will  give  relief  and  not 
bring  out  the  resourceful  side  or  cause  him  too  much  worry. 
These  are  the  things  that  make  a  physician  naturally  wonder 
why  it  is  necessary  to  practice  straight  osteopathy  when  he 
can,  by  various  methods,  relieve  himself  of  so  much  worry 
and  thinking. 

As  we  understand  it,  students  come  to  osteopathic  col- 
leges because  they  are  brave,  strong,  fearless,  and  feel  within 
themselves  that  they  are  capable  of  undertaking  tasks  that 
can  be  accomplished  very  readily  if  they  have  the  true  osteo- 
pathic spirit,  and  if  they  are  willing  sufficiently  to  educate 
themselves  that  they  will  be  able  to  stand  the  test  when  the 
crucial  tune  comes. 

After  all,  how  can  a  man  develop  if  he  is  not  put  to  a 
crucial  test?  Why  seek  the  lines  of  least  resistance,  when  a 
real  man  should  be  absolutely  fearless  and  sufficiently  inde- 
pendent, as  well  as  courageous,  to  follow  out  the  course  that 
should  be  given  him  as  demonstrated  by  the  Founder  of 
our  great  Science,  osteopathy. 

It  is  good  practice  to  write  an  occasional  thesis  or  even 
a  few  statements  regarding  the  subject  under  discussion. 
We  will  close  this  chapter  with  a  little  illustration  of  what 
a  student  might  write  in  his  junior  year,  just  for  a  pastime 
in  the  evening,  to  satisfy  himself  that  he  is  sufficiently  posted 
on  some  points  in  anatomy  to  write  it  down.  Try  this  out 
in  your  various  subjects,  and  learn  early  to  be  able  to  dictate 
to  a  stenographer.  If  you  are  not  financially  handicapped, 
keep  a  stenographer  busy  two  or  three  evenings  of  the  week, 
dictating  what  you  have  in  your  mind,  then  read  it  over 
carefully,  correcting  it,  and  you  will  be  surprised  at  how 
much  you  will  learn,  and  what  good  training  it  will  be  for 


THE  JUNIOR  61 

you  mentally,  and  how  much  more  readily  you  will  be  able 
to  think  logically,  regarding  the  various  propositions  that 
confront  a  physician. 

This  outline  is  not  complete,  but  simply  an  indication 
of  what  a  junior  might  write  out  to  test  himself  as  to  his 
knowledge  on  certain  subjects. 

Ribs 

Four  demi-facets,  two  synovial  sacs,  three  ligaments, 
three  bones  and  fibrocartilage  are  necessary  to  complete  a 
typical  costovertebral  articulation  at  the  costocentral 
point  of  attachment.  The  head  of  a  rib  is  ridged,  affording 
attachment  for  the  intra-articular  ligament  that  is  also  fixed 
to  the  intervertebral  substance.  This  forms  a  partition 
between  the  two  synovial  sacs.  The  demi-facet  on  the 
vertebra  above  forms  an  articular  cavity  for  the  rounded 
surface,  or  facet,  of  the  upper  and  inner  surface  of  the  head 
of  the  rib.  Likewise  the  lower  vertebral  facet  receives  the 
lower  rib  surface.  This  articulation  is  neatly  encompassed 
by  a  capsular  ligament,  and  further  strengthened  by  a  stellate 
ligament.  In  front  of  the  articulation,  a  portion  of  the  tho- 
racic autonomic  nerve  chain  is  found.  We  are  now  referring 
to  the  typical  thoracic  vertebrae  and  not  to  the  exceptions. 

These  series  of  arthrodial  joints  are  of  particular  inter- 
est to  the  osteopathic  physician.  It  is  hard  to  conceive  of  a 
rotated  vertebra,  or,  at  least,  a  mal-aligned  one,  in  the  tho- 
racic region  that  would  not  involve  the  costovertebral  articu- 
lation. The  facets  and  demi-facets  .in  particular  are  de- 
pendent for  their  normal  positions  upon  perfect  alignment 
of  the  spinal  column. 

A  single  lesioned  vertebra,  if  such  is  possible  to  any  de- 
gree of  independent  subluxation,  disturbs  the  articular 
costal  cavity,  formed  by  facets  in  two  bones  apposed  only 


62  PRACTICAL  VISIONS 

at  their  articular  surfaces.  The  attachment  of  a  rib  to  the 
transverse  process  of  the  vertebra  containing  the  lower 
pedicle  demi-facet  gives  us  scope  for  reasoning  out  the  me- 
chanics involved  in  an  articular  cavity  composed  of  parts  of 
two  edges  of  closely  relationed  vertebrae. 

The  exact  amount  of  rib  movement  or  deflection  pro- 
duced by  a  subluxated  vertebra  has  not  been  worked  out 
as  yet,  but  research  work  by  McConnell  and  others  has 
demonstrated  the  disturbance  registered  within  the  softer 
tissues  by  these  lesioned  vertebrae. 

A  few  interesting  points  for  students  may  be  worked 
out  upon  the  dog.  Carefully  watching  the  effect  upon  the 
comparative  stellate  ligaments  in  subluxating  a  rib  gives 
one  an  idea  of  tissue  involvements  in  lesioned  areas. 

The  tensity  of  the  superior  stellate  fibers  in  costal 
rotation  in  one  direction,  and  the  relaxation  or  corrugation 
of  the  inferior  fibers,  or  vice  versa,  demonstrate  the  amount 
of  possible  autonomic  deflection  from  a  mechanical  stand- 
point. 

But  we  are  more  interested  in  the  pathological  involve- 
ment from  a  microscopic  hemorrhagic  standpoint.  The 
distorting  of  the  vertebral  articular  double  demi-facet  cavity 
by  a  vertebral  subluxation  or  malpositioned  articular  rela- 
tionship must  occasion  microscopical  tissue  conditions  more 
or  less  perverted  in  nature. 

The  circulation  to  the  region  of  the  facets  under  dis- 
cussion comes  by  way  of  the  thoracic  intercostals.  These 
aortic  branches  passing  back  of  the  thoracic  duct,  esophagus, 
vena  azygos,  etc.,  on  the  right  side,  send  branches  not  only 
to  follow  the  costal  grooves,  but  to  enter  the  intervertebral 
foramina,  and  also  the  muscles,  tissues,  etc.,  around  the 
articular  surfaces,  including  the  facets  we  are  considering. 

The  synovial  sacs  referred  to  above,  as  well  as  those  at 


THE  JUNIOR  63 

the  transverse  processes,  are  dependent  upon  the  circula- 
tion for  their  membranous  secretions.  The  vasomotor 
nerves  controlling  the  blood  vessels  are  dependent  for  tone 
upon  the  nerve  tracts  communicating  with  the  spinal  cord 
segments  in  the  region  giving  off  the  white  rami,  the  tho- 
racic almost  exclusively. 

The  integrity  of  the  spinal  column,  therefore,  must  be 
absolute  in  order  that  no  interference  with  motor  impulses 
or  sensory  impressions  be  occasioned.  We  have  yet  to 
realize  the  full  significance  of  the  minutest  of  lesioned  areas, 
muscular,  ligamentous  or  osseous. 

The  lesioned  rib  with  its  disturbance  to  the  sympathetic 
chain  may  be  caused  through  traumatism  or  muscular  con- 
tracture,  and  not  necessarily  involve  the  vertebral  segments 
to  any  extent,  but  a  lesioned  rib,  without  a  vertebral  sub- 
luxation,  changes  the  articular  cavity  for  that  rib,  making 
one-half  of  the  cavity,  or  one  demi-facet,  out  of  line  with 
the  other  half  on  the  adjacent  vertebra. 

The  internal  border  of  the  costotransverse  ligament 
bounds  an  opening  through  which  the  posterior  branches 
of  the  intercostal  vessels  and  nerves  pass  to  supply  the  var- 
ious tissues. 

The  rotation  of  a  rib  upon  its  axis  may  partially  close 
this  opening,  or,  at  least,  bring  stress  upon  these  branches. 
The  effect  may  be  slight,  but  may  cause  disturbance  accord- 
ing to  the  degree  of  traction  and  the  function  of  the  nerve. 
The  vascular  interference  may  produce  mild  congestion. 
The  venous  effect  will  be  more  marked,  because  of  the  more 
ready  compressibility  of  the  veins.  The  nutrition,  sensation, 
motion  and  vasomotor  effect  in  this  posterior  region  nor- 
mally depends  upon  the  lack  of  pressure  along  the  course  of 
these  nerve  filaments.  The  tone  of  these  tissues  wiU  de- 
pend upon  the  freedom  of  the  vascular  branches. 


64  PRACTICAL  VISIONS 

The  intercostal  arteries  and  nerves  passing  in  front  of 
the  costotransverse  ligaments,  and  following  the  grooves  of 
the  ribs,  are  affected  in  a  different  manner.  The  subluxa- 
tion  of  a  rib  may  itself  produce  more  or  less  direct  inter- 
ference, depending  on  the  amount  of  costal  rotation.  The 
rotation  of  a  rib  sufficiently  marked  to  disturb  the  stellate 
ligament,  and  push  forward  the  sympathetic  chain  may 
cause  organic  derangement  through  the  branches  of  this 
chain  going  to  the  viscera. 

There  is  one  more  facet  in  this  region  not  yet  consid- 
ered. The  tubercle  of  each  typical  rib  articulates  with  a 
facet  on  the  transverse  process  of  the  vertebra.  Like  the 
costovertebral  articulation,  the  capsular  ligament  at  this 
point  also  encloses  a  sy  no  vial  sac;  one  only  at  this  point,  two 
at  the  vertebral  end. 

The  anterior,  middle  and  posterior  costotransverse 
ligaments  make  this  articulation  one  with  limited  motion, 
yet  a  costal  facet  for  the  tubercle  allows  sufficient  movement 
or  gliding  to  accommodate  the  changed  position  of  the  rib 
when  lesioned.  The  peculiar  curve  of  a  rib  is  well  known  to 
all,  and  the  slightest  variation  at  the  head  will  make  a  cor- 
respondingly changed  position  at  its  tubercle  attachment. 
The  effect  upon  all  muscles  attached  to  the  rib  is  more  or 
less  marked,  and  the  pressure  upon  the  vessels  and  nerve 
at  its  lower  border  are  likewise  interfered  with. 

Any  costal  rotation  brings  into  play,  and  interferes 
with,  all  tissues,  vessels  and  nerves  in  close  proximity,  and 
every  costal  subluxation  changes  at  least  two  intercostal 
spaces.  The  one  is  lessened,  the  other  is  widened.  As  in 
vertebral  lesions  no  single  vertebra  becomes  lesioned  with- 
out having  its  effect  upon  at  least  two  additional  vertebrae, 
so  no  rib  can  be  rotated  without  disturbing  at  least  two 
other  ribs. 


THE  JUNIOR  65 

Intervertebral  Discs 

There  are  twenty-three  intervertebral  discs.  The 
first  vertebra  is  not  cushioned.  The  shape  of  the  discs 
corresponds  with  the  shape  of  the  bodies  of  the  vertebrae 
in  the  three  regions  Their  thickness  varies  with  the  normal 
spinal  curve  variations.  Collectively,  they  form  almost 
one  fourth  of  the  length  of  the  spinal  column,  below  the 
axis. 

Their  composition  is  fibrocartilaginous.  Fibrous  carti- 
lage is  a  rare  tissue  in  the  human  body.  The  discs  contain 
the  greatest  collective  amount. 

The  closely  woven  bundles,  or  layers,  of  white  fiber 
make  up  the  buffers  that  absorb  shocks  in  accidents  and 
strenuous  exercises. 

The  softer  interior  of  the  discs  provides  some  flexibility 
and  the  outer  interwoven  fiber  gives  strength  to  the  spinal 
column.  The  spongy  substance  in  the  center  is  least  dis- 
turbed in  the  curvatures,  while  the  outer  or  denser  layers 
resembling  tendon  tissue  become  flattened  on  their  edges, 
where  curvature  produces  the  greatest  amount  of  pressure. 

While  the  discs  are  surrounded  by  blood  vessels,  yet 
we  find  as  a  rule  no  vessels,  and  never  any  nerves  within 
their  substance.  Cellular  fluid  sustains  their  nutriment 
and  regulates  their  growth. 

Early  curvature  affects  both  the  discs  and  the  bodies 
of  the  vertebrae.  This  refers  to  curvature  that  has  ex- 
isted for  a  period  of  time  in  the  spines  of  growing  children. 
In  later  life  the  discs  alone  are  disturbed,  or  distorted,  when 
a  reasonable  scoliosis  is  present. 

The  shape  of  the  discs  in  the  cervical  and  lumbar  regions 
is  oval,  and  in  the  thoracic,  circular.  The  large  lumbar 
discs  allow  extensive  motion  in  that  region.  The  thickness 
of  the  discs  is  not  uniform,  especially  in  the  cervical  and 

(5) 


66  PRACTICAL  VISIONS 

lumbar  regions  where  their  anterior  portions  are  consider- 
ably thicker  to  preserve  the  normal  curves.  In  the  thoracic 
region  we  have  two  additional  ligaments  attached  to  each 
disc;  the  intra-articular,  affording  attachment  to  the  heads 
of  the  ribs. 

The  smaller  thoracic  discs,  while  thinner  than  in  the 
other  regions,  are  better  protected  and  stationed.  They 
also  help  to  form  the  articular  cavities  for  the  typical  rib 
attachments. 

If  the  largest  discs  found  in  the  lumbar  region  contain 
small  synovial  cavities  as  Luschka  says,  we  are  reasonably 
sure  that  small  blood  vessels  penetrate  these  discs. 

The  surfaces  of  each  disc  are  adherent  to  the  bodies  of 
the  vertebrae  by  hyaline  cartilages.  This  is  of  interest  in 
lesioned  areas.  Just  how  much  rotation  or  subluxation  is 
necessary  to  disturb  their  attachments  is  uncertain,  but 
severely  lesioned  areas  must  tax  the  adherent  portions.  The 
flexibility  of  the  spine  is  dependent  partially  upon  the  discs, 
and  to  some  extent  upon  the  ligaments  common  to  all  verte- 
brae. 

The  anterior  and  posterior  common  ligaments  are  close- 
ly adherent  to  the  discs,  and  a  lesioned  area,  if  marked,  will 
draw  heavily  upon  these  ligamentous  fibers,  as  one  may 
observe  upon  lesioning  a  speciman  in  situ. 

The  integrity  of  the  spinal  cord  in  accident  may  be 
sustained  through  perfectly  formed  discs.  The  discs  not 
only  form  a  portion  of  the  anterior  wall  of  the  vertebral 
canal,  containing  the  cord,  but  serve  as  preventives  to  con- 
cussion in  accidents. 

The  malformation  of  discs  during  the  developmental 
period  endangers  the  cord  in  times  of  traumatism.  The 
nutrition  of  the  discs  during  the  growing  period,  indirect 
as  it  may  be,  is  an  important  factor  in  spinal  development. 


THE  JUNIOR  67 

It  is  as  necessary  that  the  discs  be  uniformly  developed  as 
it  is  that  the  bodies  of  the  vertebrae  be  normal. 

Contraction  of  the  musculature  in  the  spinal  region 
interferes  with  the  proper  development  of  the  discs  in  youth. 
The  thoracic  and  lumbar  branches  of  the  aorta  as  well  as 
those  in  the  cervical  region  supply  the  bodies  of  the  verte- 
brae as  well  as  the  adjacent  muscles  and  the  contents  of  the 
vertebral  canal.  Lesioned  areas  will  interfere  decidedly 
with  the  formation  of  both  surfaces  of  the  vertebrae,  and 
the  intervening  discs.  Every  vertebral  body  must  be  de- 
veloped to  just  such  an  extent  and  every  disc  to  a  certain 
thickness,  in  order  that  the  spine  as  a  whole  may  present  all 
of  the  normal  curves.  The  necessity  of  thorough  spinal 
relaxation  in  the  growing  child  is  obvious. 

In  Pott's  disease  the  discs  are  partially,  if  not  totally, 
destroyed.  This  makes  a  lowered  resilience  within  the 
spinal  column  and  necessitates  the  careful  avoidance  of  trau- 
matic injuries  in  preventing  cord  concussion. 

Fortunately,  a  hunch-back  is  limited  in  his  activities  and 
the  cord  and  nerves  are  thus  protected  from  severe  shock. 

The  malformation  of  the  discs  in  severe  scoliosis  may 
be  overcome  to  a  great  extent  if  the  curvature  is  obliter- 
ated before  the  period  of  full  development  has  been  reached. 
Nature  corrects  the  distorted  discs  as  well  as  the  slightly 
unevened  body  surfaces  of  the  vertebrae,  if  not  too  late. 

Spinal  tone  is  dependent  upon  normal  vascularization, 
both  in  the  veins  and  arteries.  The  correction  of  all  lesions, 
whether  osseous  or  of  the  softer  tissues,  is  imperative.  Os- 
sification in  the  vertebrae,  fortunately,  is  slower  than  in 
any  other  osseous  tissue,  and  we  consequently  have  a  greater 
opportunity  to  do  corrective  work. 

The  discs  enter  into  the  formation  of  the  foramina 
through  which  the  vessels,  nerves,  etc.,  pass.  While  the 


68  PRACTICAL  VISIONS 

presence  of  a  vertebral  lesion  does  not  necessarily  affect  the 
size  of  the  foramen,  yet  the  maldevelopment  of  a  disc  may 
allow  a  certain  amount  of  foraminal  interference.  The 
thinning  of  a  disc,  due  to  malnutrition  and  adjacent  body 
unevenness,  allows  approximation  of  the  bodies  of  ad- 
jacent vertebrae,  and  affects  the  foramen  to  a  proportionate 
degree.  If  compressed  discs  are  present  the  articulation 
suffers  readjustment,  and  the  ligaments  likewise  are  either 
hypertensed  or  over-relaxed.  The  normality  of  articulation 
of  any  two  spinal  segments  depends  upon  the  regularity  of 
the  formation  of  the  corresponding  disc. 

If  it  were  possible  for  the  discs  only  to  become  com- 
pressed or  malformed,  there  would  be  a  marked  change  in 
the  axis  of  the  vertebral  column. 

The  discs  make  the  spine  retain  its  normal  curves,  yet 
we  seldom  see  a  disc  altered  in  shape  unless  there  is  a  pro- 
portionate vertebral  disturbance. 

A  normal  disc  between  two  normal  vertebrae  means 
properly  toned  muscles  and  ligaments  in  that  particular 
area  unless  they  are  contracted  or  interfered  with  tempo- 
rarily. The  continued  presence  of  contracted  muscles  will 
tend  to  compress  the  discs  and  disturb  the  spinal  ligaments. 


CHAPTER  VII 


THE  SENIOR 


CHAPTER  VII. 

THE  SENIOR 

How  far  away  the  freshmen  look  to  a  senior!  It  seems 
like  years  have  passed  by  since  a  senior  had  his  first  lesson 
in  anatomy.  He  may  have  known  at  first  only  the  number 
of  bones  in  the  body.  He  may  also  have  had  a  short  course 
in  physiology  in  high  school,  and  possibly  he  was  sufficiently 
interested,  as  a  young  student,  to  go  to  the  extreme  limit  of 
learning  the  names  of  the  twelve  cranial  nerves.  Any  young 
man  who  will  learn  and  remember  the  names  of  these  nerves 
has  a  sporting  chance  of  ten  to  one  of  becoming  a  doctor. 
As  a  rule,  the  word  "  pneumogastric, "  may  be  remembered, 
but  "hypoglossal"  and  "spinal  accessory"  seem  a  little  too 
much  to  remember,  along  with  the  others. 

The  senior  is  in  the  polishing  process.  He  has  covered 
almost  every  subject,  at  least  the  basic  ones,  and  he  now 
turns  his  attention  to  a  grand  finale.  .He  has  mastered  each 
subject  sufficiently  to  prove  to  the  faculty  that  he  is  well 
enough  posted  to  receive  his  degree  at  the  end  of  the  four 
years'  course. 

All  kinds  of  ideas  and  plans  surge  through  his  mind. 
A  part  of  the  time  is  taken  in  dreaming  about  what  he  will 
do  and  where  he  will  locate  when  he  has  been  graduated. 
He  pictures  in  his  mind  the  establishment  of  a  practice  in 
some  nice  town  or  city,  with  a  home  on  the  hill,  a  limousine, 
every  convenience,  and  a  small  family  to  start  with.  He 
also  pictures  himself  as  being  able  to  handle  a  practice  with- 
out  any  particular  effort  and,  on  merit,  to  attract  a  goodly 
number  of  patients  and  have  these  patients  likewise  bring 
others. 

—71— 


72  PRACTICAL  VISIONS 

You  will  see  seniors  in  the  hallway  at  the  noon  hour, 
comparing  notes  as  to  the  various  prospective  fields  and 
their  respective  points  of  interest,  and  often  the  graduate 
doctor  locates  in  an  entirely  different  section  from  what  he 
intended  when  he  first  entered  college. 

Too  much  time  should  not  be  spent  in  dreaming  about 
days  to  come,  as  it  may  interfere  with  the  final  year's  prog- 
ress sufficiently  to  make  one  lose  a  part,  at  least,  of  what  he 
really  should  have  in  order  to  be  a  well-rounded  student. 

There  are  a  number  of  subjects  that  will  be  gone  over 
in  the  senior  year,  that  were  dealt  with  from  an  elementary 
standpoint  in  previous  years.  There  are  also  a  number 
of  new  phases  that  will  be  of  more  than  casual  interest  to  a 
senior. 

The  last  year  is  the  most  pleasant  of  all,  in  that  you 
have  the  basic  principles  of  the  various  subjects,  and  you 
have  a  clearer  idea  of  what  the  work  really  should  be.  Some- 
times it  takes  almost  two  years  before  the  real  osteopathic 
vision  is  clearly  worked  out.  I  have  heard  students,  after 
being  in  college  for  months,  say  that  after  a  certain  lecture 
they  really  got,  for  the  first  time,  the  true  osteopathic  con- 
cept. It  is  quite  different  now,  when  osteopathy  is  better 
known,  and  teachers  have  a  better  way  of  presenting  osteo- 
pathic principles  and  truths,  when  so  many  cases  have 
been  treated  all  over  the  world,  and  so  many  good  results 
have  been  obtained,  than  it  was  years  ago,  when  we  were 
practically  groping  our  way  in  a  new  science. 

Anatomy,  to  a  senior,  seems  comparatively  easy.  He 
has  become  familiar  with  the  relationship  of  the  various 
structures.  He  knows  the  innervation  of  all  the  muscles; 
the  articulation  of  the  body  is  quite  familiar.  He  is  also 
well-posted  on  the  ossification  of  the  various  bone  centers. 
Physiology  to  him  is  quite  complete,  in  that  he  has  been 


THE  SENIOR  73 

trained  to  make  observations  regarding  physiological  ac- 
tivities in  the  human  system.  Pathological  phases  are 
likewise  interesting,  as  he  has  been  trained  from  the  micro- 
scope to  the  clinic  cases  under  observation,  to  discern  and 
determine,  and  to  reason  from  cause  to  effect,  as  to  the  pro- 
gress of  the  various  diseases  under  consideration. 

He  has  passed  a  sufficient  number  of  examinations  to 
familiarize  himself  with  the  writing  of  answers  to  questions 
from  a  little  broader  viewpoint.  He  weaves  in  a  bit  of 
physiology,  pathology,  also  symptomatology,  in  some  of 
the  answers  to  questions  on  anatomy,  for  instance.  While 
he  may  be  over-stepping  the  bounds  to  a  certain  extent, 
yet  he  feels  contented  in  that  he  has  familiarized  himself 
with  the  subject  from  every  standpoint. 

He  is  a  wise  student  who  will  continue  to  make  rough 
sketches  or  drawings  of  the  various  anatomical  parts.  In 
this  way,  he  will  be  able  to  master,  to  a  great  extent,  the 
sympathetic  nervous  system.  He  will  become  familiar 
with  the  various  ganglia.  He  will  be  able  to  write  three  or 
four  pages  on  any  one  of  the  important  ganglia.  For  in- 
stance, on  the  superior  cervical  ganglia,  he  will  make  notes 

something  like  this : 

*  *  * 

Behind  the  carotid  sheaths  and  opposite  the  2nd  and 
3rd  cervical  vertebrae,  lie  two  ganglia  forming  the  upper- 
most part  of  the  chain  we  refer  to  as  the  autonomic  nervous 
system.  Through  these  ganglia  pass  vasoconstrictor  im- 
pulses to  the  arteries  of  the  head  and  face.  Were  it  possible 
to  visualize  the  physiological  mechanics  and  workings  tak- 
ing place,  we  would  see  a  flood  of  impulses,  originating  in 
the  upper  thoracic  region,  passing  by  way  of  the  anterior 
spinal  nerves  to  and  through  the  first  thoracic  ganglia,  and 
upward  through  the  middle  cervical  to  the  superior  ganglia. 


74  PRACTICAL  VISIONS 

Here  the  preganglionic  fibers  terminate,  to  be  extended  as 
postganglionic  fibers.  The  many  nerve  fibers  that  branch 
from  the  superior  ganglia  contain  the  vasomotor  fibers  that 
control  the  vascular  tissues  found  in  the  head  and  face. 
These  nerve  fibers  follow  the  course  of  the  arteries  mainly. 
Thus  we  find  the  cavernous  and  carotid  plexuses  in  the 
head,  and  the  pharyngeal  plexus  in  the  neck.  The  position 
of  the  superior  cervical  ganglia  in  relation  to  the  cervical 
vertebrae  is  of  interest  from  an  applied  anatomy  standpoint. 
We  are  all  familiar  with  the  clinical  import  of  spinal  nerve 
interference,  but  with  ganglionic  disturbance  we  have  a 
more  indirect  perversion. 

Cervical  subluxations,  while  causing  tissue  traction 
upon  spinal  nerves  and  vessels,  cannot  be  said  to  exert  a 
direct  pressure  upon  the  free  ganglia  suspended  or  stretched 
in  front  of  the  vertebrae.  We  must  remember,  however, 
that  all  spinal  nerves  are  connected  with  ganglia  of  the  au- 
tonomic  system  by  gray  rami,  while  the  cervical  nerves 
give  no  direct  white  rami  to  the  cervical  ganglia.  Thus  the 
problem  is  explained  regarding  the  preganglionic  fibers 
to  the  head  passing  through  the  ganglia  from  the  upper 
thoracic,  where  the  first  white  rami  are  given  off. 

This  leads  to  a  second  proposition.  The  first  referred 
to  cervical  lesions  affecting  the  ganglia  by  way  of  the  gray 
fibers,  while  this  refers  to  thoracic  lesions  affecting  the  su- 
perior cervical  ganglia  by  way  of  the  white  rami  that  con- 
vey the  preganglionic  fibers.  A  good  example  of  this  is 
the  effect  upon  the  ciliary  muscles  and  iris  when  the  nerve 
fibers  in  the  ciliospinal  nerve  center  are  interfered  with.  A 
lesion  at  the  second  dorsal  may  not  only  affect  the  ciliary 
muscles,  but  cause  ophthalmic  vascular  disturbance  as  well. 

A  third  interference  with  the  superior  cervical  ganglia 
may  arise  from  disturbance  with  the  middle  cervical  ganglia 


THE  SENIOR  75 

or  even  the  first  thoracic.  Any  pressure  along  the  course 
of  the  preganglionic  fibers  to  the  superior  cervical  ganglia 
will  result  in  perversion. 

The  superior  cervical  ganglia  give  off  the  superior 
cardiac  nerves,  which  influence  the  cardiac  muscles.  Re- 
flexly,  cardiovascular  disturbance  varies  arterial  tension 
and  affects  vasomotor  control. 

The  normal  heart,  with  regular  pulse  rate  within  its 
arterial  offshoots,  allows  normal  vasomotor  control,  provid- 
ing no  interference  with  the  vasomotor  fibers  exists. 

The  absence  of  lesions  or  contracted  musculature  en- 
sures  normal  physiological  action  within  the  vasomotor 
mechanism.  The  superior  cervical  ganglia  with  their  many 
branches,  ascending,  anterior,  etc.,  if  normal,  allow  perfect 
control  of  their  vasoconstrictor  fibers,  which  are  in  a  state 
of  tonic  action.  The  presence  of  lesions  causes  immediate 
disturbance  proportionate  to  the  amount  of  interference 
with  nerve  fibers. 

The  normality  of  physiological  impulses  depends  upon 
the  entire  absence  of  lesioned  areas  in  the  broadest  sense. 

It  is  a  question  whether  a  cervical  lesion  is  of  more  im- 
portance in  regard  to  a  superior  cervical  ganglionic  per- 
version than  is  an  upper  thoracic,  but  we  know  that  the 
simple  correction  of  a  cervical  lesion  will  not  restore  normal 
tone  to  the  superior  cervical  ganglia  if  there  exist  thoracic 
lesions.  We  might  carry  the  point  still  further  and  include 
systemic  derangements,  but  we  are  confining  ourselves  as 
closely  as  possible  to  direct  impingements  and  local  lesions 
as  immediate  causative  factors. 

The  communications  existing  between  the  superior 
cervical  ganglia  and  certain  cranial  nerves  (5th,  9th,  10th, 
12th)  enable  us  to  secure  control  reflexly  of  many  conditions 
that  arise  in  the  head  and  face. 


76  PRACTICAL  VISIONS 

The  stimulation  of  certain  cervical  nerves  and  correc- 
tion of  cervical  lesions  influence  salivary  secretion,  tic  symp- 
toms, neuralgic  phases,  glandular  tone,  etc.  The  adjust- 
ment of  upper  thoracic  lesioned  areas  will  influence  not 
only  the  eyes  but  many  of  the  tissues  under  vasomotor  con- 
trol. Epistaxis  may  be  checked  at  a  point  as  low  as  the 
second  thoracic. 

While  it  is  a  disputed  point  regarding  the  vasomotor 
supply  of  various  cephalic  vessels  in  the  circle  of  Willis  and 
beyond,  yet  we  have  proven  clinically,  at  least,  that  the  regu- 
lation of  circulation  cephalad  may  be  almost  perfectly  con- 
trolled through  the  influence  of  manipulation  in  the  regions 
mentioned.  The  arrangement  of  the  circle  of  Willis  with 
its  double  supply  of  vessels  in  the  protected  cervical  trans- 
verse processes — the  vertebrals — and  the  free  vessels — 
the  carotids — hi  front  of  the  vertebrae  and  in  close  relation 
with  the  superior  cervical  ganglia,  gives  us  an  opportunity 
for  regulating  the  encephalic  circulation  through  the  upper 
three  or  four  ganglia.  Osseous  lesioned  areas  may  disturb 
more  or  less  directly  the  vertebral  arteries,  while  muscular 
contracted  tissues  may  influence  the  carotids. 

Besides  this  more  or  less  direct  influence,  we  still  have 
the  central  vasomotor  influence  which  may  be  primary  or 
secondary. 

The  brain  centers  originating  the  general  vasomotor 
impulses  may  also  be  influenced  through  lesions  in  the  cervical 
or  upper  dorsal  regions. 

Because  of  the  connection  of  the  superior  cervical 
ganglia  with  the  9th  and  10th  cranial  nerves,  their  function 
is  affected  according  to  the  amount  of  lesion  disturbance. 
The  delicacy  of  the  autonomic  system  renders  it  liable  to 
variations,  and  the  slightest  stimulus  may  affect  the  periph- 
eral fibers  that  are  distributed  through  the  head  and  face. 


THE  SENIOR  77 

The  superior  cervical  ganglia  control  the  vast  majority 
of  cephalic  vasomotor  impulses  and  we  must  not  expect 
normal  conditions  to  exist  unless  we  adjust  every  lesioned 

area,  great  or  small. 

*  *  * 

A  little  practice  along  this  line,  continued  for  a  few 
years,  will  enable  any  student  to  present  a  subject  in  a  way 
that  will  do  himself  justice. 

How  the  days  drag  out!  Graduation  day  seems  far 
away  at  the  beginning  of  the  fourth  year,  and  were  it  not 
for  the  various  new  subjects  that  are  taken  up  in  the  last 
year,  it  might  become  more  or  less  tedious. 

A  knowledge  of  the  X-Ray  is  most  satisfying.  The 
lectures  on  medical  jurisprudence  are  always  appreciated, 
and  differential  diagnosis  is  a  most  important  subject.  Diag- 
nosis, in  any  instance,  under  any  heading,  is  of  great  value 
to  any  student  or  physician.  The  lectures  on  hygiene,  pub- 
lic health,  diet,  are  most  valuable,  but  through  it  all,  the 
senior  should  look  forward  to  a  day,  not  only  of  graduation, 
but  one  wherein  he  will  have  so  acquired  the  habit  of  study 
and  research  that  he  will  feel  that  it  is  only  the  beginning 
for  a  structure  that  will  be  builded  upon  the  outline  pre- 
sented in  the  four  years  at  college. 

The  greatest  men  who  have  ever  practiced  therapy  of 
any  kind,  have  done  their  most  wonderful  work  after  being 
in  the  field  for  some  time,  or  by  teaching  after  having  been 
graduated.  It  takes  experience  to  accomplish  new  things 
and  work  out  new  ideas,  along  therapeutic  lines,  and,  after 
all,  four  years  preparation  in  college  is  but  the  cornerstone 
of  a  foundation  that  should  be  well  builded  upon. 


CHAPTER  VIII 


GRADUATION 


CHAPTER  VIII. 

GRADUATION 

Naturally  a  student  entering  college  looks  forward  to 
graduation  day  with  great  anticipation.  It  seems  like  a 
long  hard  road  when  a  student  enters  college  and  many  a 
time  during  the  college  course  he  wonders  whether  he  will 
ever  be  ready  for  graduation,  and  especially  when  studying 
some  of  the  deeper  subjects  he  feels  as  if  he  will  never  be 
able  to  pass  on  those  subjects  in  the  final  examinations. 

However,  a  goal  is  necessary  in  any  race,  and  when  grad- 
uation day  comes  those  who  take  part  are  usually  over- 
joyed and  the  feeling  of  satisfaction  when  handed  a  diploma 
is  possibly  unequalled  by  any  sensation  known  during  the 
college  course. 

It  does  not  necessarily  mean  that  the  student  is  a  capable 
physician  because  he  has  been  graduated  with  honors. 
There  are  those  who  pass  better  in  their  subjects  than  any 
one  else;  there  are  also  those  who  receive  gold  medals  and 
class  honors,  but  we  have  noted  with  great  interest  that 
some  of  the  best  physicians  that  have  ever  gone  through 
college  did  not  stand  particularly  high  in  their  classes  in 
the  way  of  grade  marks. 

Well  do  I  remember  a  young  man  from  one  of  the  Central 
States,  in  our  class,  who  did  not  seem  to  pay  any  particular 
attention  to  the  lectures  and  who  never  seemed  to  pass  with 
any  great  credit  marks  in  the  final  examinations,  but  this 
same  doctor  became  one  of  the  best  known  physicians  hi 
New  York  City.  He  seemed  to  have  a  natural  tendency 
along  the  line  of  handling  people;  his  patients  have  implicit 
confidence  in  him  and  he  handles  some  of  the  most  elite  in 
that  great  city. 

—81— 
16) 


82  PRACTICAL  VISIONS 

We  cannot  always  judge  as  to  who  will  become  famous, 
when  sitting  in  the  benches  at  college.  We  never  know  what 
a  man  has  in  his  mind.  Also  we  never  know  the  viewpoint 
or  the  vision  that  a  young  man  has  when  he  is  listening  to 
the  lectures  from  day  to  day.  There  is  such  a  thing  as 
mental  development  along  unusual  lines  if  certain  nerve 
tracts  are  put  into  use.  Sometimes  it  is  the  instructor  who 
brings  out  in  certain  students  a  peculiar  mental  phase  that 
means  everything  to  the  student,  although  the  professor  is 
not  aware  of  what  is  going  on  in  the  mind  of  one  who  is 
sitting  under  him  for  instruction. 

Physicians,  like  artists,  are  born,  seldom  made.  It  is  a 
peculiar  profession  and  unless  a  young  man  is  absolutely 
adapted  to  handling  the  sick  and  really  has  a  liking  for  that 
particular  work,  it  is  almost  useless  for  him  to  study  any  one 
of  the  branches  of  the  therapeutic  art. 

Years  ago  I  knew  of  a  boy  who  dissected  practically 
everything  in  the  farmyard  that  he  could  get  his  hands  on. 
His  mother  found  him  one  day  dissecting  a  chicken.  He 
was  sufficiently  kind-hearted  not  to  perform  vivisection. 
This  young  man  turned  out  to  be  one  of  the  great  surgeons 
in  North  America.  He  absolutely  craved  surgical  work. 
His  whole  mind  and  thought  were  along  the  one  line. 

The  older  idea  was  for  a  parent  with  three  boys  to  try 
to  induce  them  to  become  either  lawyers,  doctors  or  min- 
isters. Time  has  reversed  the  proposition  and  boys  as  a 
rule  are  allowed  to  choose  their  own  calling.  This  is  most 
fortunate.  Even  as  it  is,  a  great  many  physicians  leave  their 
work  and  go  about  other  duties. 

When  old  Dr.  Still  was  alive  it  was  his  greatest  delight 
to  attend  graduation  exercises.  Those  of  us  who  were 
fortunate  enough  to  go  through  college  when  he  was  still 
the  head  of  it,  remember  with  great  pride  the  time  when  he 


GRADUATION  83 

handed  us  our  diplomas,  or  stood  on  the  platform  and  in- 
structed the  dean  or  some  member  of  the  faculty  to  hand 
them  to  us.  He  usually  gave  us  a  few  words  of  good  advice 
and  usually  those  words  stuck  to  us  for  many  years.  He 
gave  us  the  impression,  which  was  quite  correct,  that  we 
should  not  expect  to  have  perfect  success  when  first  entering 
into  practice,  and  that  we  would  find  in  a  few  years 
that  we  still  had  something  to  learn,  and  that  we  never 
would  learn  all  there  was  to  be  known.  At  the  same 
time  he  gave  us  great  encouragement  and  told  us  that  the 
basic  principle  regarding  the  management  of  a  practice  was 
to  have  confidence  in  yourself,  and  never  forget  that  the 
body  is  a  machine  and  that  the  Creator  placed  within  that 
body  all  of  the  necessary  requirements  for  perfect  physio- 
logical functionings. 

There  is  something  most  satisfying  about  receiving 
a  diploma  hi  that  you  feel  that  you  have  won  the  confidence 
of  the  faculty  as  well  as  those  who  have  control  of  the  insti- 
tution, and  you  likewise  feel  that  you  have  something  to 
back  you  up  when  you  open  your  office.  About  the  first 
thing  a  young  doctor  does  when  fitting  up  his  office  is  to 
hang  his  diploma  in  a  conspicuous  place  where  his  patients 
and  friends  can  see  that  he  is  duly  qualified  to  enter  into  his 
work  with  proper  backing. 

There  is  something  else  about  graduation  that  appeals 
to  the  one  who  has  completed  his  course  in  a  satisfactory 
manner,  and  that  is  the  fact  that  he  has  been  sufficiently 
studious,  and  has  entertained  a  proper  vision  sufficient  to 
enable  him  to  comprehend  the  various  teachings  that  have 
been  presented  to  him  from  day  to  day  during  the  college 
course.  His  mind  is  carried  back  by  listening  to  'the  Class 
President's  address,  to  those  days  when  he  first  realized  the 
significance  of  the  healing  art. 


84  PRACTICAL  VISIONS 

The  first  few  months,  he  remembers,  were  befogged 
by  various  theories  presented  in  the  text  books,  and  it 
took  some  time  for  a  young  man  to  clarify  these  in  his 
mind,  and  appreciate  the  fact  that  it  is  possible  through 
physiological  stimulation  or  otherwise  to  control  the  var- 
ious parts  and  organs  of  the  human  body.  It  is  a  happy 
day  for  a  student  when  he  realizes  that  he  has  a  good  idea  of 
the"  great  vasomotor  system,  and  knows  it  is  a  physiological 
fact  that  certain  nerve  centers  control  the  caliber  of  the 
blood  vessels,  and  also  regulate  to  a  greater  or  less  degree  the 
functioning  of  the  various  organs.  Possibly  he  will  recall  with 
the  greatest  of  pride  the  days  when  pathology  became  clear 
to  him,  and  that  physiology  may  be  turned  into  pathology 
by  a  perverted  blood  stream,  therefore  appreciating  to  the 
fullest  extent  the  statement  made  by  Dr.  Still  that  the  rule 
of  the  artery  is  supreme,  and  that  at  the  very  moment  the 
general  circulation  is  interfered  with,  that  moment  physi- 
ology becomes  pathology. 

Many  things  will  pass  through  the  mind  on  gradu- 
ated day,  but  possibly  the  one  that  will  stand  out  clearer 
than  all  others  is  the  fact  that  when  a  student  is  gradu- 
ated he  is  thrown  on  his  own  resources  and  will  be  re- 
sponsible for  the  cases  under  his  direction.  There  will  be 
no  professors  or  clinical  advisers  to  assist  you  in  the  field. 
You  may  have  access  to  fellow  practitioners  or  you  may 
be  in  a  small  place  where  you  are  the  only  one  practicing, 
but  the  acute  feeling  experienced  by  the  majority  of  grad- 
uates is  that  they  are  thrown  out  into  the  world  to  battle 
alone.  Therefore,  a  student  who  has  been  a  close  observer, 
who  day  by  day  has  taken  a  keen  interest  in  the  lectures 
presented  to  him,  and  who  in  the  clinic  room  has  observed 
minutely  all  kinds  of  symptoms,  will  feel  when  he  estab- 
lishes a  practice  of  his  own  that  he  has  had  experience 


GRADUATION  85 

before,  and  sufficient  confidence  in  his  ability  to  go  ahead 
and  handle  the  case  or  cases  that  are  under  his  care. 

For  some  time  after  graduation  the  young  doctor  is 
likely  to  write  back  to  the  school  and  especially  to  some  one 
professor  to  whom  he  has  taken  a  particular  fancy,  asking 
advice  along  certain  lines.  After  a  graduate  is  out  for  a 
few  years,  he  drifts  away  from  this  habit  and  having  had  a 
great  deal  of  experience  through  those  years,  he  possibly 
feels  that  he  is  in  a  position  to  give  advice  to  some  of  the 
other  physicians  who  have  not  had  equal  experience. 
This  method  of  assisting  one  another  is  of  great  value  to 
the  young  practitioners  in  particular,  and,  as  a  rule,  they 
appreciate  it  most  highly. 

Graduation  is  only  the  beginning  of  greater  things,  if 
the  student  is  in  reality  a  student.  The  doctor  who  fails 
to  remain  a  student  all  of  his  life  is  the  one  who  will  never 
reach  any  great  height,  and  the  doctor  who  studies  the  most 
after  graduation  is  the  one  who  received  a  proper  vision  when 
going  through  college  in  that  he  realized  that  college  work 
is  only  frame  work  and  on  that  frame  work  the  real  struc- 
ture should  later  on  be  built. 


CHAPTER  IX 


OPENING  AN  OFFICE 


CHAPTER  IX. 

OPENING  AN  OFFICE 

The  majority  of  graduates  want  to  open  their  own  offices. 
They  feel  that  they  can  do  better  practicing  alone.  There 
are  a  few,  however,  who  would  prefer  taking  a  post-graduate 
course  or  specializing  along  some  line,  or  even  going  in  under 
some  older  practitioner  for  a  year  or  two.  This  same  idea 
exists  in  the  business  world.  There  are  some  men  who  go 
through  business  college,  and  receive  all  the  training  that 
another  man  does,  yet  they  feel  that  they  would  like  to  work 
under  some  one  and  sometimes  this  is  best. 

The  man  with  initiative  and  determination  to  accom- 
plish great  things  along  original  lines  almost  invariably 
paddles  his  own  canoe.  We  will,  therefore,  discuss  in 
this  chapter  the  physician  who  launches  his  barque  and 
pushes  out  and  away  from  shore. 

We  welcome  the  young  practitioner.  The  field  is 
great.  There  never  wrill  be  too  many  practitioners  in  our 
day,  although  sometimes  the  undergraduates  feel  that  the 
field  is  pretty  well  filled  up.  This  is  a  great  mistake.  There 
is  greater  need  at  the  present  time  for  osteopaths  than 
ever  before.  There  are  many  towns  where  there  is  no 
practitioner  and  there  are  cities  of  half  a  million  popula- 
tion where  only  a  score  of  practitioners  try  to  handle  the 
work. 

No  line  of  work  is  overcrowded  so  far  as  high-class 
work  is  concerned.  Not  all  inventions  have  yet  been  made, 
not  all  poems  have  yet  been  written  and  we  have  as  yet  to 
find  an  artist  who  will  paint  on  canvas  the  real  colorings 
that  nature  produces  in  a  sunset. 

—89— 


90  PRACTICAL  VISIONS 

No  physician  as  yet  has  been  able  to  make  a  complete 
diagnosis  in  a  chronic  invalid.  The  pathological  findings 
in  an  autopsy  never  quite  agree  with  the  diagnosis  given 
by  the  physician  when  the  patient  was  still  alive.  No 
known  method  of  diagnosis  is  as  yet  complete,  and  no  two 
physicians  absolutely  coincide  in  their  views  and  beliefs 
regarding  anything  from  dietetic  measures  to  the  real  ex- 
isting nerve  reflexes  that  take  place  in  a  systemic  disturb- 
ance. A  practitioner  may  feel  that  he  has  practically  diag- 
nosed a  case  and  that  he  has  verified  his  findings  regarding 
specific  lesions,  and  that  he  has  tested  all  of  the  reflexes, 
made  complete  chemical  urinalyses  and  recorded  accurately 
various  bacterial  findings,  but  what  physician  living  can 
state  the  absolute  condition  of  certain  areas  in  the  ductless 
glands,  for  instance,  without  verifying  them  either  by  sur- 
gical exploration  or  later  on  by  an  autopsy? 

So  we  find  that  there  is  great  room  for  the  young  stu- 
dent to  spend  an  hour  or  two  each  day  in  study,  going  over 
his  various  text  books  that  he  had  just  left  in  college  and  re- 
arranging in  his  mind  comparative  propositions,  first  from  a 
physiological  standpoint,  symptomatological  and  finally 
pathological.  He  will  begin  to  realize  that  the  nerve  im- 
pulses that  were  so  carefully  considered  in  physiology  are 
altered  in  systemic  diseases  where  pathology  reigns  supreme. 

We  have  referred  in  the  previous  chapter  to  the  di- 
ploma hanging  on  the  wall.  Sometimes  this  diploma  will 
look  very  fine  indeed.  Other  days  when  confronted  by 
clinic  propositions,  it  will  seem  as  if  it  meas  nothing. 

After  practising  for  almost  a  quarter  of  a  century,  I  am 
going  to  take  the  liberty  of  giving  a  little  advice  along  the 
line  of  establishing  a  new  practice,  and  will  first  deal 
with  the  selection  of  an  office. 

Before  locating  in  any  place,  it  is  well  to  visit  that  place 


OPENING  AN  OFFICE  91 

and  satisfy  yourself  that  you  are  willing  to  settle  down  and 
stay  there  until  you  have  sufficiently  established  yourself, 
and  won  the  hearts  of  the  people  by  administering  to  them 
as  a  true  physician  does.  After  that  you  need  not  worry, 
as  you  will  want  to  remain. 

As  a  rule,  the  best  location  for  an  office  is  not  in  a  resi- 
dence, but  in  the  downtown  district.  The  rents  may  be  a 
little  higher,  you  may  feel  that  you  can  economize  by  having 
an  office  in  your  house,  but  it  will  not  be  many  months  before 
you  will  realize  that  you  have  made  a  mistake,  and  you  will 
feel  that  you  want  to  move  down  town  where  you  can  be 
within  reach  of  the  business  men  and  the  shopping  throngs. 
There  is  no  doubt  in  my  mind  that  the  difference  in  rent  is 
too  minor  a  proposition  even  to  consider.  There  are  so 
many  points  of  advantage  in  having  an  office  down  town  in 
our  line  of  work,  that  any  other  proposition  should  scarcely 
be  considered.  You  should  seek  an  office  in  a  large  central 
building. 

It  is  a  mistake  for  many  reasons  to  have  an  office  in  a 
residence.  You  naturally  want  to  get  away  from  the  place 
where  you  sleep  and  eat.  From  a  psychological  standpoint, 
it  is  refreshing  to  go  downtown  to  your  office,  get  your  mail, 
handle  your  patients,  make  your  outside  calls  and  return 
home  in  the  evening  refreshed  because  it  is  a  change. 

There  are  many  other  points  we  might  bring  out  re- 
garding the  disadvantage  of  having  an  office  in  your  house. 
One  that  is  worth  while  is  that  if  you  are  practising  in  your 
residence,  you  are  not  as  likely  to  be  on  hand  to  meet  pa- 
tients as  if  you  were  in  an  office  down  town  away  from 
home  environment.  There  are  always  a  number  of 
things  to  do  around  a  house  and  especially  if  you  are  not 
financially  able  to  have  a  maid,  you  are  liable  to  feel 
that  you  should  assist  in  some  of  the  household  duties,  and 


92  PRACTICAL  VISIONS 

the  first  thing  you  know  you  will  be  lifting  something  or 
helping  to  clean  something  in  the  house,  and  you  will  appear 
fussed  and  mussed  when  you  should  be  concentrating  on 
your  work. 

There  is  a  thrill  about  spinning  down  to  the  office  in  the 
morning  ready  for  a  day's  work,  and  entering  as  if  you 
were  sole  proprietor — even  if  you  are  paying  rent — and 
master  of  the  situation  in  that  it  depends  upon  your  skill 
and  ability  to  handle  successfully  the  cases  that  present 
themselves.  Have  regular  office  hours  and  stick  to  them. 
Get  into  the  habit  of  going  to  your  office  a  few  minutes 
before  it  is  time  to  commence  your  work.  When  you 
enter  your  office  in  the  morning  go  into  each  of  the 
treatment  rooms,  see  that  everything  is  in  proper  shape  even 
though  you  may  have  one  or  more  assistants,  and  even  a 
graduate  nurse.  See  for  yourself  that  everything  is  arranged 
to  your  liking  by  going  through  the  rooms  before  any  pa- 
tient enters.  You  accustom  yourself  to  the  room  and  feel 
when  you  enter  to  treat  a  patient  that  since  you  have  been 
there  before,  you  are  familiar  with  conditions  as  they  exist 
for  that  day. 

Some  doctors  like  a  central  room  with  a  treatment 
table  and  a  number  of  adjacent  dressing  rooms.  In  my  own 
mind,  I  feel  that  the  better  arrangement  is  to  have  a  num- 
ber of  treatment  rooms,  and  again  psychology  enters  in 
that  going  from  one  room  to  another  I  am  facing  different 
surroundings,  and  I  find  it  more  or  less  refreshing.  Each 
room  should  invariably  have  a  fan  in  it  for  all  year  round  use. 
The  corridor  as  well  as  private  office  should  likewise  have 
fans.  The  first  thing  I  do  in  the  morning  is  to  start  all 
the  fans  going,  opening  the  windows,  and  it  seems  to  put  life 
into  the  place. 

Possibly  I  should  have  been  a  mechanic  and  worked  in 


OPENING  AN  OFFICE  93 

some  great  factory  where  the  wheels  are  eternally  buzzing 
during  the  working  hours,  but  I  find  that  the  revolving  wheel 
is  symbolic  of  life,  or  better  stated  activity,  and  the  first  five 
or  ten  minutes  in  the  morning  a  physician  can  tune  himself 
for  the  day's  work.  You  can  picture  in  your  mind  the 
number  of  patients  that  will  enter  your  door  that  day,  the 
manner  in  which  you  will  handle  them,  the  interest  that  you 
will  take  in  them  and  the  results  that  you  expect  to  get  in 
each  and  every  case.  The  results  are  the  fascination  of  hav- 
ing new  patients  come  in  and  if  you  have  been  practising 
for  some  time,  former  patients  to  drop  in  and  cheer  you  up 
by  telling  you  how  much  better  they  feel. 

Years  ago  I  remember  an  old  doctor  saying  that  the 
greatest  pleasure  in  his  life — the  happiest  moments — were 
those  when  some  former  patient  would  stop  him  on  the 
street  and  say  "Hello,  Doc.  you  did  me  a  world  of  good 
when  I  was  under  your  care.  I  am  feeling  a  thousand  per 
cent,  better."  I  have  never  forgotten  the  statement  that 
old  doctor  made,  and  at  the  time  I  was  not  a  physician.  I 
wondered  if  the  old  doctor  was  sentimental,  as  it  appeared 
to  me  that  there  were  a  great  number  of  things  that  would 
interest  a  doctor  more  than  to  have  a  mere  statement  handed 
to  him  by  some  former  wreck  who  had  been  under  his  care, 
but  as  the  years  go  by,  I  realize  that  the  doctor  was  right. 
Nothing,  absolutely  nothing,  gives  a  doctor  that  peculiar 
thrill  except  such  a  statement  made  by  a  grateful  patient. 

Going  back  to  our  office  work,  the  physician  should  be 
in  such  good  physical  trim  when  his  patients  enter,  that  he 
will  appeal  to  them  as  one  who  knows  a  great  deal  about  the 
human  body  because  he  himself  radiates  health  and  happiness 
and  at  the  same  time  inspires  confidence.  You  must  be  in 
perfect  trim  physically  or  your  patients  will  observe  it.  If 
you  have  a  bad  cold  and  a  little  cough,  they  will  certainly 


94  PRACTICAL  VISIONS 

mention  it.  If  your  hands  are  cold  they  will  also  mention 
it.  You  simply  must  radiate  healthful  thoughts  backed  up 
by  a  good  physique  if  you  expect  your  patients  to  have  full 
confidence  in  you. 

There  was  a  time  when  a  physician  could  look  wise, 
say  little  and  get  away  with  it,  but  in  this  day  and  age  when 
people  are  constantly  reading,  in  the  papers  and  mag- 
azines, articles  that  are  almost  absolutely  technical,  and 
when  various  physicians  are  writing  along  health  lines,  and 
discussing  various  symptoms  and  diseases  from  tic 
douloureux  to  nephritis,  we  find  that  they  are  sufficiently 
posted  to  make  good  use  of  the  interrogation  point,  and 
the  physician  absolutely  must  be  posted  on  every  line  of 
his  work,  or  the  patient  will  lose  confidence  in  him. 

We  will  not  dwell  on  the  personal  appearance  of  a  doc- 
tor and  refer  to  his.  mannerisms  or  peculiar  habits,  neither 
will  we  make  any  particular  reference  to  the  necessity  of 
absolute  cleanliness  and  ideas  along  the  line  of  being  well 
dressed  and  well  groomed.  No  reference  will  be  made  to 
the  wearing  of  spotless  linen  and  the  need  of  daily  attention 
to  the  hands  in  particular,  as  no  physician  could  go  through 
college  and  not  observe  these  details,  but  we  will  state  frank- 
ly that  there  are  those  who  have  forgotten  these  minor 
points,  and  we  have  seen  doctors  wearing  soiled  linen.  We 
have  also  seen  rough  hands,  digital  mourning,  and  lack  of 
tonsorial  care.  We  have  often  wondered  what  peculiar 
psychology  those  physicians  harbored  when  after  high  school 
and  a  college  course,  they  were  so  unthoughtful  that  they 
could  not  appreciate  the  fact  that  a  physician  above  all 
men  should  keep  himself  in  a  spotless  condition. 


CHAPTER  X 


THE  PHYSICIAN 
HIMSELF 


CHAPTER  X. 

THE  PHYSICIAN  HIMSELF 

Allow  me  to  address  you  today  as  I  would  talk  to  you 
in  my  own  office  if  you  asked  me  how  I  thought  a  young 
practitioner  should  prepare  himself  to  handle  a  heavy  prac- 
tice. It  is  necessary  to  refer  to  my  own  methods  in  order 
that  I  may  give  you  an  idea  of  what  I  have  found  works 
out  satisfactorily  in  a  down  town  office. 

I  have  had  the  experience  of  conducting  a  practice  in 
my  own  residence.  I  have  also  had  the  experience  of  shar- 
ing an  office  with  another  doctor,  and  I  am  satisfied  in  my 
own  mind  that  in  the  majority  of  cases,  the  only  satisfactory 
method  in  the  long  run  is  to  open  up  the  best  office  possible 
in  a  large  downtown  building. 

I  may  have  peculiar  ideas  as  to  just  how  a  physi- 
cian should  conduct  himself  and  keep  himself  physically 
fit  in  order  to  handle  a  practice,  and  while  I  have  made  ref- 
erence to  handling  a  large  practice,  it  is  not  necessary  for 
every  one  to  attempt  this,  and  a  great  many  will  not  want 
to  handle  too  large  a  practice.  However,  after  years  of 
experience,  you  will  possibly  feel  as  I  do,  that  a  physician 
who  does  not  handle  more  practice  each  year,  get  better 
results,  give  shorter  treatments  and  at  the  same  time  under- 
stand his  patients'  conditions  more  minutely  than  the  year 
previous,  is  not  a  progressive  physician. 

We  will  refer  in  this  chapter  in  particular  to  the  care 
a  physician  should  take  in  keeping  himself  physically  fit  in 
order  that  he  may  conduct  his  practice  in  a  manner  satisfac- 
tory both  to  himself  and  his  patient.  Regardless  of  stature, 
weight,  or  anything  along  that  line,  you  will  find  it  a  most 

—97— 
(7) 


98  PRACTICAL  VISIONS 

serious  handicap  if  you  do  not  have  sufficient  sleep  and  rest 
in  order  that  you  may  feel  keen  and  alert  when  you  go  to 
your  office.  There  are  some  physicians  who  feel  that  in 
order  to  establish  a  practice  in  a  new  town  or  city  they 
must  develop  the  social  side  and  be  well  thought  of  in  the 
various  clubs,  churches,  societies,  and  so  forth.  This  may 
be  perfectly  proper  in  many  instances,  but  I  have  always  held 
the  opinion  that  the  doctor  who  is  absolutely  attending  to 
his  practice,  and  while  not  busy  with  patients  is  looking 
over  reference  books,  and  posting  himself  on  certain  dis- 
eases, is  the  man  who  will  make  the  greatest  progress  in 
handling  and  developing  a  practice.  Patients  like  to  know 
that  their  doctor  is  keeping  abreast  with  the  times,  that  he 
takes  all  the  latest  magazines,  that  he  is  familiar  with  the 
latest  discoveries  along  the  lines  of  diagnosis  and  treat- 
ment and  from  an  osteopathic  standpoint  the  physician 
who  is  best  posted  on  anatomy,  especially  applied  anatomy, 
is  the  one  who  will  have  the  best  results. 

There  is  no  getting  away  from  the  fact  that  the  work 
of  the  osteopath  is  a  great  deal  more  strenuous  than  that 
of  the  old  school  physician.  We  are  called  upon  to  give 
out  a  great  deal  of  strength  and  energy,  and  unless  we  are 
physically  fit,  or  at  least  keep  ourselves  in  a  condition  where 
a  patient  will  not  take  too  much  out  of  us,  in  plain  speak- 
ing, we  will  not  be  able  to  handle  many  cases  a  day  and  get 
satisfactory  results.  Therefore  I  feel  that  if  an  osteopath  is 
really  desirous  of  accomplishing  great  things  and  really 
wants  to  have  a  large  practice,  he  must  make  preparations 
for  handling  that  practice. 

It  may  be  all  right  to  drive  your  own  car,  but  do  not 
think  of  changing  tires  or  overhauling  -your  car,  or  doing 
anything  that  will  in  any  way  take  too  much  energy  out  of 
you.  Reserve  your  energy  for  your  patients.  There  will 


THE  PHYSICIAN  HIMSELF  99 

come  certain  days  when,  even  though  you  are  strong  and 
physically  fit,  you  will  feel  as  if  you  have  to  work  that 
day  almost  in  a  mechanical  manner.  You  may  be  a  bit 
depressed  through  some  news  you  have  received,  or  possibly 
a  letter  will  disturb  you — we  are  all  more  or  less  sensitive 
along  certain  lines — but  by  having  a  reserve  amount  of 
energy,  you  will  find  that  you  can  get  through  the  day  very 
nicely,  and  by  a  little  extra  sleep  and  rest  the  next  day  you 
will  be  perfectly  adjusted  mentally  and  physically. 

If  you  play  golf,  wear  gloves,  but  do  not  attend  to  your 
furnace,  carry  out  ashes  or  work  in  the  garden.  Reserve  your 
physical  strength  and  you  will  make  much  better  headway. 
If  driving  a  car  makes  you  nervous  and  you  reach  your 
office  in  more  or  less  of  an  agitated  manner,  you  are  in  no 
condition  to  handle,  for  instance,  a  case  of  neurasthenia. 
Enter  your  office  in  the  morning  after  having  a  good  break- 
fast and  if  you  smoke,  a  good  Havana,  feeling  that  you  are 
perfectly  capable  of  handling  any  number  of  patients  that 
day;  also  that  you  are  sufficiently  clear  minded  to  re- 
member in  detail  what  your  patient  has  told  you  at  a  pre- 
vious time,  and  with  that  buoyancy  of  spirit  that  should 
exist  in  a  physician,  take  hold  of  your  cases  with  confidence 
and  without  talking  proceed  to  make  your  corrections,  and 
make  the  patient  realize  that  he  is  receiving  the  best  of 
attention.  This  does  not  apply  to  the  first  two  or  three  pa- 
tients in  the  morning,  but  it  applies  to  the  patients  that 
come  in  last  in  the  afternoon.  Have  sufficient  reserved 
energy  to  give  your  patient  at  4:30  the  same  thorough  spe- 
cific treatment  that  you  did  at  9  o'clock  in  the  morning. 

Have  your  own  private  office  where  you  can  retreat 
occasionally  and  sit  for  a  few  moments  collecting  your 
thoughts,  and  feel  that  you  are  giving  the  patient  the  best 
attention  that  you  possibly  can  give  him. 


100  PRACTICAL  VISIONS 

In  our  chapter  on  free  clinics  we  will  refer  to  the  matter 
of  giving  these  cases  the  same  thorough  consideration  that 
you  do  your  best  paid  cases.  Always  give  your  patient  the 
idea  and  be  sincere  about  it,  that  his  particular  case  is  the 
star  case,  and  assure  him  that  you  are  going  to  bring  him 
back  to  health  in  the  quickest  possible  manner.  This  in- 
variably holds  good  whether  the  patient  is  worth  fortunes  or 
is  a  clinic  case.  When  people  are  sick,  as  a  rule,  they  want 
to  get  well  as  quickly  as  possible,  and  the  more  speedy  the 
recovery  the  greater  the  credit  to  you. 

If  you  can  make  the  correction  that  will  bring  about 
restoration  in  one  specific  treatment,  do  it,  even  though  the 
patient  may  be  able  to  take  treatment  for  six  months, 
without  feeling  any  financial  strain.  If  you  can  create 
the  impression  honestly  that  you  are  virtually  a  magician 
at  healing,  you  will  find  it  invaluable  because  back  of  it  all 
it  will  mean  that  you  are  a  good  diagnostician,  that  you 
understand  human  anatomy,  that  human  nature  is  an  open 
book  to  you,  that  you  are  capable  of  dealing  with  new  cases 
without  hesitation,  and  with  the  greatest  of  confidence. 
You  will  thus  get  the  reputation  of  being  one  who  gets 
his  cases  out  in  the  quickest  possible  time. 

This  will  not  mean  that  you  are  slighting  your  pa- 
tients in  the  way  of  diagnosis,  as  some  may  think.  It  will 
not  mean  that  you  are  hurrying  through  with  a  case  and 
giving  short  treatments,  but  it  will  create  an  impression  in 
time  that  you  know  your  work,  and  that  you  are  perfectly 
capable  of  handling  your  cases  in  some  way  or  other  that 
brings  about  the  best  results. 

It  is  as  necessary  for  a  physician  to  eat,  as  for  any 
other  person,  and  possibly  more  so,  especially  in  our  line  of 
work  where  we  have  to  feel  the  strain  of  handling  many 
patients.  Eat  your  meals  regularly.  Let  your  patients 


THE  PHYSICIAN  HIMSELF  101 

know  that  your  luncheon  hour  is  at  a  certain  time 
and  that  you  will  not  see  them  until  you  return. 
Needless  to  say,  it  is  necessary  for  a  physician  as  well 
as  his  patient  to  eat  something  warm  at  each  meal. 

Likewise  office  hours  are  absolutely  essential  and  must 
be  respected.  If  your  hours  are  from  nine  until  five  with 
intermission  for  luncheon,  be  sure  that  your  last  appoint- 
ment is  such  that  you  will  be  through  by  five  o'clock,  and  do 
not  allow  yourself,  unless  in  an  emergency  case,  to  remain 
in  your  office  after  five  o'clock.  If  you  do,  you  will  find 
that  one  half  hour  after  five  o'clock  will  take  more  out  of 
you  than  the  afternoon's  work  did.  Respect  your  own 
feelings  and  your  patients  will  act  accordingly.  After  all 
it  is  a  matter  not  of  one  day's  practice,  but  day  after  day. 

There  are  times  in  every  physician's  life  when  he  feels 
as  if  he  would  like  to  exchange  with  the  other  man,  and 
only  by  regular  office  hours  and  regular  eating  will  it  be 
possible  for  an  osteopathic  physician  to  hold  up  under  the 
strain  of  a  large  practice  and  keep  physically  fit.  It  is 
possible  to  do  this  by  regularity.  If  you  will  excuse  a  per- 
sonal reference,  I  will  say  that  in  the  last  twelve  years  I  have 
been  confined  to  the  house  but  one  day,  and  this  was  due 
to  catching  cold  by  riding  in  a  shower  while  going  to  an 
emergency  case.  It  was  impossible  to  seek  protection  and 
at  the  same  time  arrive  at  the  destination  where  duty  called 
me. 

Day  after  day  it  is  a  pleasure  to  go  to  the  office  and 
treat  those  who  come  for  help  and  feel  at  the  same  time  as  if 
through  regular  habits  there  is  sufficient  reserved  ener- 
gy to  enable  one  to  do  justice  to  his  patients  as  they  are 
treated  one  by  one. 

There  are  tunes  in  every  physician's  practice  when 
apparently  everything  seems  to  go  wrong.  There  are  also 


102  PRACTICAL  VISIONS 

times  when  we  have  a  great  number  of  cases  on  our  hands 
that  are  serious  in  nature,  and  there  are  other  times  when 
we  feel  as  if  we  are  not  getting  the  results  that  should 
be  expected.  The  only  thing  to  do  in  these  instances  is 
to  do  our  best.  It  seems  like  a  simple  rule  but  it  works, 
and  if  you  continue  to  give  your  best  service  you  will  find  in 
a  few  days'  time  that  things  will  clear,  your  patients'  condi- 
tions will  change,  and  with  the  exception  of  one  or  two 
cases,  everything  will  come  out  lovely. 

I  have  found  it  a  very  good  rule  to  be  absolutely  frank 
with  patients,  with  very  few  exceptions,  and  tell  them  their 
true  condition  regardless  of  what  it  is,  and  I  have  no  hesi- 
tancy whatever  in  not  taking  a  case  if  I  feel  that  there  is 
something  about  the  condition  that  warrants  refusal.  We 
cannot  expect,  even  after  years  of  practice,  to  understand 
every  case,  and  wise  is  the  doctor  who  states  frankly  that  he 
would  rather  not  take  the  case  for  certain  reasons.  You 
need  not  give  these  reasons.  You  will  not  be  forced  to  give 
them,  but  your  patient  as  a  rule,  will  respect  your  statement 
and  compliment  you  on  your  frank  manner  in  making  the 
statement. 

The  physician  must  be  an  optimist.  He  must  have  the 
disposition  to  look  sufficiently  far  ahead  that  he  will  be 
able  to  encourage  his  patient,  and  justify  himself  in  giving 
the  encouragement  in  that  he  understands  better  than  the 
patient,  the  real  condition. 

There  are  some  people  who  believe  that  weather  condi- 
tions have  no  effect  upon  them,  that  they  should  feel  as  well 
on  a  rainy  day  or  before  a  storm  as  on  a  bright  sunshiny 
day.  Wise  is  the  physician  who  will  handle  the  situation 
without  disturbing  to  any  great  extent  the  patient's  reason- 
ings. 

There  are  also  patients  who  may  have  psychic  neurosis 


THE  PHYSICIAN  HIMSELF  103 

or  may  be  sufficiently  temperamental  to  be  agitated  or  dis- 
turbed by  home  environment  or  business  conditions,  and 
the  all-round  physician  should  likewise  be  able  to  handle  this 
attitude  of  mind  in  a  way  that  will  assist  the  patient  to  over- 
come his  disturbed  condition  and  bring  about  a  restoration 
of  health  regardless  of  the  type  of  disease  condition  that 
may  exist. 

We  are  of  the  opinion,  however,  that  in  no  mental  case 
of  any  form  from  hysteria  to  dementia  praecox  will  there  be 
found  an  absence  of  specific  osseous  lesions.  We  have  never 
as  yet  seen  a  case  of  hysteria  for  instance,  that  was  not 
backed  up  by  a  perverted  physiological  activity  in  which 
some  pressure  or  circulatory  irregularity  existed  in  some  part 
of  the  human  body.  From  an  osteopathic  standpoint  we 
are  supposed  to  consider  a  patient  not  only  from  a  mental 
standpoint  in  which  suggestion  and  instruction  along  physio- 
logical lines  is  sufficient,  but  we  are  supposed  to  examine 
the  patient's  framework,  palpate  the  various  organs  and 
determine,  if  possible,  a  cause  wherein  pressure  may  exist 
in  some  form  or  other.  People,  as  a  rule,  will  not  complain 
unless  there  is  something  to  complain  about.  A  perfectly 
well  person  rarely  exists,  it  is  true,  and  the  majority  of  peo- 
ple have  some  complaint,  but  there  is  most  often  some  hidden 
condition  back  of  the  complaint,  that  may  lead  to  a  neurotic 
condition  or  a  disturbed  mental  state  sooner  or  later. 

In  the  great  institution  at  Macon,  Missouri,  as  well  as 
one  or  two  other  similar  institutions  where  for  years  osteo- 
paths have  handled  mental  cases,  we  have  found  out  that 
these  cases  are  restored  to  health  after  corrective  work  has 
been  done  as  well  as  proper  suggestion  from  a  therapeutic 
standpoint,  and  sometimes  in  the  very  same  cases  that  were 
not  benefited  in  older  institutions  where  corrective  work  was 
not  a  part  of  the  treatment.  The  physician  must  be  many- 


104  PRACTICAL  VISIONS 

sided,  and  each  day  will  bring  up  different  problems  as  no  two 
cases  are  exactly  the  same,  and  the  physician  who  handles 
a  large  practice  is  the  one  who  is  best  posted  on  the  various 
phases  of  diagnosis  and  treatment.  Without  a  doubt,  the 
greatest  results  have  been  obtained  in  the  majority  of  in- 
stances  by  the  application  of  the  principles  as  taught  and 
laid  down  by  Dr.  A.  T.  Still,  founder  of  osteopathy. 


CHAPTER  XI 


MAKE  A  FRESH 
DIAGNOSIS  EVERY  DAY 


CHAPTER  XI. 

MAKE  A  FRESH  DIAGNOSIS  EVERY  DAY 

Walk  through  a  dense  forest,  stop  at  some  vantage 
point  and  look  through  the  thickly  spaced  trees,  and  you 
will  have  one  viewpoint.  Move  forward  six  feet,  look  in 
apparently  the  same  direction,  and  you  will  have  another 
viewpoint. 

Ninety-nine  per  cent  is  one  point  higher  than  ninety- 
eight  per  cent.  Suppose  we  make  a  diagnosis  one  day,  and 
we  feel  justified  in  saying  that  we  have  made  an  accurate 
diagnosis.  The  next  day  we  vary  our  diagnosis  slightly, 
according  to  some  new  subjective  symptom  that  has  pre- 
sented itself,  giving  us  a  better  insight  into  the  case  and 
adding  at  least  one  per  cent  to  our  total  viewpoint. 

It  is  not  a  bad  idea  in  some  cases  to  make  what  we  have 
termed  for  years,  a  double  examination.  As  a  rule  new 
cases,  that  is,  chronic  cases  that  come  to  us  for  the  first  time, 
usually  select  a  day  in  which  they  feel  the  best,  in  order  to 
present  the  best  side  to  the  doctor,  and  give  the  physician 
the  impression  that  they  are  able  to  "come  back,"  so  to 
speak,  and  be  restored  very  readily  by  his  method  of  treat- 
ment. In  order  to  checkmate  this  attitude  upon  the  part 
of  the  patient,  we  quite  often  give  a  second  examination  be- 
fore attempting  to  treat  the  person  as  a  regular  patient. 

After  the  first  examination,  we  select  a  'second  day, 
which  may  be  the  next  day  or  two  weeks  hence.  If,  for 
any  reason,  the  patient  does  not  come  on  the  day  that  we 
have  selected,  we  surmise  at  least  that  he  is  again  choosing 
a  day  on  which  he  feels  the  very  best. 

It  is  humanly  impossible  for  any  physician  of  any 
school  of  therapy  to  make  a  one  hundred  per  cent  diagnosis 

—107— 


108  PRACTICAL  VISIONS 

in  any  case.  We  may  strive  to  that  end,  and  there  are  some 
physicians  who  are  very  accurate,  and  who  pride  themselves 
on  being  fine  diagnosticians,  and,  undoubtedly,  they  are 
almost  specialists  in  that  line,  if  such  an  expression  might 
be  applied  to  any  physician  making  accurate  diagnoses. 

The  X-ray  will  not  reveal  the  condition  of  the  finer 
tissues  and  cells,  in  that  at  the  present  stage  it  is  at  best 
merely  a  designator  of  shadows.  We  are  therefore  inclined 
to  say  that  until  it  is  possible  to  discover  some  method,  if 
ever  it  can  be  discovered,  that  will  give  us  a  true  insight 
into  the  physiological  and  particularly  the  pathological 
conditions  of  the  tissues  in  all  parts  of  the  body,  we  will 
remain  handicapped. 

Some  physicians  find  it  quite  difficult  to  diagnose  be- 
tween chicken-pox  and  small-pox,  for  instance,  and  this 
is  mostly  surface  symptom  diagnosing.  Again,  some  phy- 
sicians will  dispute  the  cause  of  acne.  Still  others  fail  to 
appreciate  the  significance  of  sacs  under  the  eyes.  Thus 
we  might  go  down  the  line  of  surface  symptoms,  as  we  may 
term  them,  from  varicose  veins  to  furuncles,  and  the  man 
who  would  state  absolutely  that  he  is  sufficiently  posted 
to  make  an  absolute  diagnosis  in  any  and  all  instances,  is 
walking  on  dangerous  ground.  We  thus  see  that  the  ex- 
amination of  today,  also  the  diagnosis,  may  not  be  the  same 
as  that  of  tomorrow.  We  have  not  the  same  viewpoint 
any  two  days.  We  are  supposed  to  know  more  each  day 
than  on  the  previous  day.  We  are  constantly  learning 
something  about  the  human  body,  and  the  keen,  alert  phy- 
sician will  never  stop  learning.  The  mind  develops;  our 
viewpoint  changes,  as  we  classify  and  re-arrange  in  our 
minds,  certain  symptoms  that  lead  up  to  certain  conditions 
that  are  practically  never  the  same  in  any  two  cases. 

In  no  instance  are  there  two  cases  absolutely  parallel. 


MAKE  A  FRESH  DIAGNOSIS  EVERY  DAY  109 

Getting  down  to  a  fine  point,  in  no  two  cases  are  nerves  ever 
affected  to  the  same  extent;  or  sections  of  the  spinal  cord 
ever  involved  in  the  same  degree;  or  blockage  of  the  circu- 
lation, or  lymph  flow,  ever  quite  the  same.  The  impulses 
are  never  the  same  rate  in  one  person  as  in  another.  The 
autonomic  reflexes  differ  according  to  the  condition  of  the 
nerves,  circulation  and  tissue  tone.  We  may  have  a  typ- 
ical case  of  Bell's  palsy.  Yet  no  two  cases  have  ever  been 
absolutely  the  same  in  every  detail.  The  final  terminals 
of  the  nerves  may  be  involved  to  a  different  degree  in  one 
instance  than  in  another.  The  circulation  to  these  nerves 
may  be  disturbed  from  a  different  standpoint.  The  in- 
stability of  the  nerve  in  its  relation  to  the  central  nervous 
system,  as  well  as  its  connection  with  other  nerve  fibers, 
is  never  quite  the  same  in  any  two  instances. 

Thus  we  have,  when  it  comes  to  diagnosing  a  case,  a 
peculiar  proposition,  in  that  the  human  body  is  not  only  a 
machine,  but  a  chemical  laboratory,  a  pulsating  collection 
of  cells  and  tissues,  controlled  by  certain  nerve  centers, 
where  instability  is  realized  according  to  certain  principles 
in  the  way  of  stimulating  forces,  circulatory  inequalities, 
and  so  forth. 

No  patient  is  in  the  same  condition  one  day  as  on  a 
previous  day.  The  chemistry  of  the  body  changes.  The 
internal  secretions  vary.  The  vasomotor  tone  is  not  con- 
stant. The  reflexes  act  according  to  the  central  nerve  con- 
trol with  its  many  indirect  actions.  The  fluids  in  the  body 
are  not  equalized  according  to  the  various  regions  on  various 
occasions.  One  day  there  may  be  mild  cephalic  congestion. 
Another  day,  through  over-exertion  and  fatigue,  an  excess 
of  fluid  may  be  found  in  the  region  of  the  ankles;  and  still 
another  day  there  may  be  a  tendency  towards  venous  stasis 
in  the  mesenteric  area. 


110  PRACTICAL  VISIONS 

The  tension  of  the  muscles  is  not  the  same  on  any  two 
days.  We  are  affected  by  draughts,  exposures,  torsions, 
exercises,  excitement,  dietetic  indiscretions,  mental  de- 
pression, worry,  overwork,  or  one  of  the  many  other  phases 
that  confront  the  majority  of  people. 

There  is  a  tendency  in  the  physiological  functionings 
of  the  human  body  to  work  in  cycles.  One  day  we  may  be 
depressed,  for  some  practically  unknown  reason.  This 
may  be  due  to  an  interference  with  the  metabolism  of  the 
body.  Another  day  we  may  be  exhilarated,  also  for  some 
unknown  reason,  and  express  ourselves  by  saying  that  we 
never  felt  better.  The  next  day,  also,  for  some  unknown 
reason,  we  may  have  an  embolus  lodge  in  a  cerebral  artery 
and  produce  the  symptoms  so  well  known  subjectively  and 
objectively.  Apparently  in  perfect  health  one  day,  the 
next  day  a  patient  may  come  down  with  typhoid  fever,  or 
a  child  may  develop  mumps,  measles,  diphtheria,  or  other 
of  the  numerous  infections. 

Wherein,  then,  is  it  possible  for  a  physician  to  be  cer- 
tain at  any  time,  other  than  to  state  that  along  the  line  of 
general  principles  certain  improvements  should  take  place 
through  certain  measures,  if  there  are  no  idiosyncrasies? 

The  art  of  diagnosing,  and  it  is  an  art  if  absolutely 
correct,  is  given  to  but  few  men.  The  majority  of  physi- 
cians, while  they  may  think  they  know  how  to  diagnose, 
fail  to  discern  certain  symptoms  and  conditions  that  are 
existing,  from  a  metabolic  standpoint,  within  the  human 
body. 

No  physician  without  making  the  tests  can  tell  whether 
a  patient  is  immune  to  vaccine  virus  or  not.  Neither  can 
a  physician  tell  with  accuracy  beforehand  whether  or  not  a 
certain  given  dosage  will  affect  that  person  the  same  as 
another.  We  have  as  yet  failed  to  recognize,  previous  to 


MAKE  A  FRESH  DIAGNOSIS  EVERY  DAY  111 

testing,  that  peculiar  physical  condition  known  as  immunity, 
and  we  have  also  yet  to  learn,  without  making  certain  tests, 
just  how  much  a  person  can  stand  in  the  way  of  exercise  or 
even  manipulation  and  adjustment,  without  making  the 
tests. 

Thus,  we  find  that  we  are  as  yet,  after  all  of  these  years, 
only  in  the  experimental  stage,  and  that  there  is  sufficient 
room  for  research  work  and  diagnostic  findings  to  keep  our 
physicians  busy  for  many  years  hence,  developing  certain 
phases  that  are  yet  not  understood,  by  the  majority  of 
physicians  at  least. 


CHAPTER  XII 


"NOT  THAT,  BUT  THIS" 


CHAPTER  XII. 

"NOT  THAT,  BUT  THIS" 

On  our  golf  links  there  is  a  man,  fifty  years  of  age,  with 
a,  most  commanding  manner,  with  whom  it  is  a  pleasure  to 
play,  for  you  invariably  learn  something.  His  favorite 
expression  is  "Not  that,  but  this."  Should  you  lose  a  hole 
to  him,  he  cheers  you  up  by  saying,  at  the  next  tee,  when 
you  are  recalling  your  mistakes,  "  Not  that,  but  this,  Doctor," 
and  you  feel  as  if  you  are  ready  to  start  life  anew. 

Sometimes  a  single  expression  will  change  your  view- 
point, and  if  it  is  of  an  optimistic  nature,  will  produce  ex- 
hilaration. Suppose  we  have  had  a  case  that  has  not  re- 
sponded as  nicely  as  we  would  have  liked;  let  us  go  to  the 
next  patient  saying  to  ourselves  "Not  that,  but  this,"  and 
determine,  in  a  most  decided  manner,  to  make  the  greatest 
possible  restoration  in  the  least  possible  time 

Seldom  do  we  see  a  man  who  is  so  full  of  optimism, 
whose  liver  and  spleen  are  of  sufficient  normality  to  produce 
constant  and  well-regulated  tone  in  the  body;  but  when  we 
do  find  a  man  who  is  bubbling  over  with  energy;  who  seems 
to  live  on  the  hill-tops;  it  is  most  refreshing,  indeed. 

Walking  out  of  the  dining  room  one  day,  I  met  a  man 
with  his  wife  and  child,  a  little  boy  of  six.  The  man  was 
about  five  feet  eleven,  straight  as  an  arrow,  well  dressed 
and  you  could  see  by  his  mental  attitude  that  he  was  a 
constant  source  of  inspiration  to  the  boy,  not  to  mention 
the  happy  smile  on  the  face  of  the  wife,  who  seemed  to  think 
that  he  was  the  only  man  in  the  world. 

Alertness  is  one  of  the  great  essentials  in  this  life.  "Do 
it  now"  is  the  greatest  single  mental  stimulant  that  we  know 

—115— 


116  PRACTICAL  VISIONS 

of.  This  book  contains  chapters  on  both  of  these  subjects — 
"Alertness"  and  "Do  it  Now." 

No  man  has  ever  held  an  important  position,  who  has 
not  felt  at  times  that  he  was  not  accomplishing  as  much  as 
he  possibly  might,  and  there  are  times  in  every  man's  life 
when  he  feels  as  if  he  needs  the  counsel  and  cheer  of  a  good 
friend. 

It  is  quite  impossible  to  be  so  perfectly  fit  that  we  will 
feel  each  day  of  the  year  that  we  are  absolutely  capable  of 
filling  our  positions.  There  are  times  when  everything  seems 
to  go  wrong;  there  are  certain  days  that  are  dark  days.  In 
the  financial  world  and  the  professional  world,  there  are 
times  when  things  seem  almost  to  reach  a  crisis,  and  wise  is 
the  man  who  can  so  steady  himself  that  he  will  live  through 
the  crisis  and  come  out  from  the  rapids  into  the  calm,  placid 
waters  of  logical  reasoning. 

"Each  morning  is  a  new  beginning,"  as  Ralph  Waldo 
Trine  wrote  in  his  famous  book  years  ago,  when  psychology 
was  practically  a  novelty  and  when  the  occult  was  almost 
uncanny. 

No  man  can  rise  in  the  morning  prepared  for  a  great 
day's  work,  not  having  made  preparation  the  night  before. 
It  is  well  to  keep  your  mental  books  at  night;  arrange  your 
program  for  the  following  day,  and  on  first  wakening  in  the 
morning  recall  some  special  event  that  is  to  happen  that 
day,  or  some  particular  piece  of  work  that  you  have  planned 
out  that  will  be  for  the  betterment  of  humanity.  After  all, 
we  live  a  life  of  service.  To  serve  is  the  greatest  thing  in 
this  world,  and  that  day  is  lost  when  at  nightfall  we  have 
not,  in  some  manner  or  other,  influenced  for  good  the  life 
of  some  one  person  at  least.  We  perhaps  had  in  mind  the 
accomplishment  of  some  great  piece  of  work.  We  may  have 
figured  on  doing  some  particular  research  work,  and  through 


"NOT  THAT,  Bur  THIS"  117 

stress  of  circumstances,  peculiar  environment,  or  financial 
stress,  felt  as  if  we  were  subdued  and  weighted  down.  No 
man  has  ever  lived  who  has  been  absolutely  free  from  grief, 
sorrow,  or  even  pain.  Disappointment  comes  even  to  those 
who  have  so  fitted  themselves  in  life  that  others  feel  that 
they  have  neither  worry  nor  care. 

In  our  college  days  we  have  possibly  dreamed  of  a  time 
when  we  would  have  so  mastered  our  subjects  that  to  make 
a  diagnosis  would  be  not  only  easy,  but  absolutely  certain; 
but,  strange  to  say,  no  two  cases  have  ever  been  exact  dupli- 
cates, and  no  two  sets  of  symptoms  have  ever  been  ex- 
actly the  same.  The  human  machine  varies,  as  far  as  symp- 
toms are  concerned,  as  strikingly  as  do  the  faces  of  any  two 
comparative  persons.  Phrenologists  state  that  no  two 
heads  have  ever  measured  exactly  the  same;  that  no  two 
brains  have  ever  weighed  exactly  the  same  amount;  and  the 
mental  capacity  of  no  two  great  personages  has  ever  tallied 
in  every  respect.  We  are  individuals.  We  are  made  up 
of  individual  cells.  Every  cell  in  the  living  body  is  an  ani- 
mated piece  of  tissue.  The  capability  of  a  cell  has  never 
been  understood.  The  possibilities  of  tissues  depend  upon 
the  great  central  nervous  system  that  awakens  them  to  the 
extent  that  they  are  not  only  nourished,  but  are  forced  to 
function  according  to  the  forces  that  exist  in  the  body. 

It  is  well  to  arrange  in  our  minds  early  in  life  the  exact 
condition  of  things;  to  realize  the  potentialities  of  the  human 
organism;  the  peculiar  maneuvering  of  the  human  brain; 
the  wonderful  actions  and  re-actions  of  the  various  nerve 
centers,  and  the  capabilities  of  the  reflexes.  Were  it  possible 
for  a  man  to  be  in  the  most  perfect  tone  at  any  and  all  tunes, 
from  a  physical  standpoint,  and  have  a  cerebrum  that  is 
capable  of  constant  and  continuous  development  to  the 
extent  that  each  day  no  derangement  would  exist,  in  the 


118  PRACTICAL  VISIONS 

way  of  counter  forces,  and  were  it  possible  for  a  man  to  have 
instructions  and  live  in  an  environment  wherein  he  would 
practically  be  at  school  all  of  his  life,  under  teachers  who  were 
perfectly  capable  of  instructing  from  a  standpoint  that  would 
be  not  only  analytical  but  judicial;  we  would  find  the  human 
brain  would  reach  a  point  of  development  that  has  never 
been  known  in  the  history  of  man. 

The  minute  we  stop  learning,  or  feel  that  we  have 
nothing  to  learn  from  our  fellow  beings,  that  moment  we 
have  mental  stasis,  if  such  a  thing  could  exist.  The  person 
of  receptive  mind;  the  good  listener;  the  man  who  feels  that 
he  can  learn  something  from  every  human  being  with  whom 
he  comes  in  contact,  is  the  man  who  will  develop  the  most. 

There  should  be  no  such  thing  as  class  rule,  sets,  or 
castes,  but  a  feeling  that  each  mind  is  distinctive  in  itself, 
and  that  every  personage  we  meet  contains  in  his  brain,  at 
some  point,  information  that  we  do  not  possess.  Let  the 
other  fellow  talk.  Be  a  good  listener.  Say  little,  unless 
called  upon;  and  keep  a  mental  poise,  or  balance,  that  will 
not  necessarily  reflect  wisdom,  but  that  will  assure  you  that 
you  are  practically  master  of  the  situation,  in  that  you  are 
sufficiently  open-minded  to  entertain  the  ideas  and  thoughts 
of  all  those  who  are  walking  the  various  paths  of  life. 

It  was  never  intended  that  we  should  agree  with  every 
person.  It  is  quite  as  necessary  for  a  variety  of  beliefs  in 
all  the  various  religions,  political  groups,  therapies,  and  so 
forth,  as  it  is  for  each  individual  to  have  his  own  peculiar 
characteristics.  Let  us  welcome  the  situation;  appreciate 
it;  and  arrange  ourselves  in  such  a  manner  that  we  will  de- 
velop and  retain  individualistic  viewpoints.  It  is  a  sign  of 
lack  of  initiative  to  rely  upon  the  judgment  of  another  en- 
tirely. It  is  also  a  sign  of  weakness  to  be  an  imitator. 

The  brain  should  be  considered  a  mental  laboratory, 


"Nor  THAT,  Bur  THIS"  119 

in  which  we  work  out  various  problems  each  day,  and  con- 
sidering  the  brain  from  that  standpoint,  it  should  be  a  pleas- 
ure to  work  in  this  mental  laboratory  and  see  how  much  we 
can  accomplish  in  a  year's  time. 

Tucked  away  in  the  recesses  of  the  brain,  as  well  as  in 
the  great  central  nervous  mechanism,  are  records,  count- 
less in  number;  impressions  made  from  the  sensitive  retina, 
conveyed  by  the  optic  nerve  and  commissures,  to  areas  of 
the  brain  that  have  a  capacity  for  holding  millions  upon 
millions.  Registered,  also,  in  the  areas  of  the  brain,  are 
sounds  conveyed  by  the  auditory  nerve  through  that  won- 
derful mechanism  of  the  middle  and  internal  ear,  that,  if 
properly  filed  and  indexed,  would  fill,  in  our  business  meth- 
ods of  reasoning,  a  store  house  of  such  great  magnitude  that 
we  could  not  secure  sufficient  clerks  to  do  the  filing.  We 
have,  within  our  cerebral  cortex,  the  most  wonderfully  con- 
tracted piece  of  mechanism  that  was  ever  created  by  the 
hand  of  God.  The  capabilities  of  the  human  brain  are  be- 
yond ah1  comprehension.  Were  we  to  live  a  thousand  years 
and  retain  our  physical  vitality,  we  could  not  begin  to  store, 
within  this  great  mental  warehouse,  the  records  that  could 
be  made  from  day  to  day. 

To  be  in  perfect  physical  trim  should  make  the  possessor 
of  the  perfect  organism  a  perfectly  contented  human  being. 
The  greatest  asset  that  any  man  can  have  is  perfect  health. 
He  does  not  always  realize  this,  and  he  is  not  always  cap- 
able of  appreciating  what  perfect  health  means;  but,  as  a 
working  basis,  a  man  with  fair  mental  capacity  and  perfect 
health  should  linger  long  and  dwell  many  years  without  show- 
ing the  signs  of  old  age. 

When  you  become  discouraged  and  feel  as  if  you  had 
lost  your  game,  say  to  yourself,  "Not  that,  but  this!" 


CHAPTER  XIII 


ALERTNESS 


CHAPTER  XIII. 

ALERTNESS 

Were  it  possible  for  me  to  believe  in  re-incarnation,  and 
could  I  return  again  to  this  mundane  sphere,  for  a  change  I 
believe  I  should  like  to  come  back  as  a  squirrel. 

For  years  we  have  had  in  our  yard,  black  and  gray 
squirrels.  They  come  over  from  the  park,  which  is  only  a 
block  away.  I  have  often  fed  these  squirrels  just  to  study 
one  thing — alertness.  Many  a  time  I  have  watched  them 
steal  an  ear  of  corn,  carry  it  into  the  trees,  and  finally  throw 
down  the  cob  after  eating  away  every  kernel.  It  is  well 
worth  the  value  of  the  corn  to  watch  their  maneuverings. 

We  have  always  been  taught  that  a  cat  is  about  as 
quick  as  any  animal,  but  in  the  yard  I  have  many  a  time 
observed  a  squirrel  teasing  a  cat,  and  the  utmost  helpless- 
ness on  the  part  of  the  cat  in  trying  to  catch  the  squirrel — 
up  and  down  the  tree,  on  all  sides,  up  on  the  limbs,  dropping 
to  the  ground,  running  up  another  tree,  while  the  cat  sat 
watching  most  intently,  waiting  for  an  opportunity  to  grab 
the  squirrel. 

Possibly  the  position  of  the  squirrel's  eyes  has  some- 
thing to  do  with  its  alertness.  We  know  that  they  have 
mandibles  that  are  beyond  all  mental  comprehension.  We 
are  familiar  with  hydraulic  power,  but  the  manner  in  which 
the  squirrel  twirls  a  nut,  finds  a  peculiar  soft  area  by  dental 
palpation,  opens  this  encrusted  capsule  containing  meat, 
all  in  a  moment's  time,  leads  us  to  believe  that  we  have 
something  yet  to  learn. 

Now,  what  application  has  a  squirrel  to  a  human  being? 

First  of  all,  we  have  no  school  or  training  in  which  we 
are  taught  alertness.  We  are  told,  when  children,  to  watch 

—123— 


124  PRACTICAL  VISIONS 

out  for  autos  passing,  street  cars  gliding  by,  and  all  manner 
of  moving  vehicles.  We  are  also  taught  to  avoid  this  thing 
and  that,  but  we  are  not  sufficiently  trained  in  alertness. 
We  will  stand  talking  on  a  street  corner,  with  the  wind  blow- 
ing on  the  backs  of  our  necks,  when  we  know  full  well  that 
we  will  suffer  with  a  cold  in  two  or  three  days'  time. 

We  allow  our  teeth  to  become  more  or  less  decayed, 
and  pyorrhea  to  take  possession,  when  we  know  that,  had 
proper  treatment  been  applied,  these  various  conditions 
might  be  avoided. 

Unless  deterred  by  a  policeman,  the  majority  of  people 
will  jay-walk  across  the  corners.  There  seems  to  be  a  lack 
of  alertness  in  all  of  our  movements  People  will  slop  along 
the  street  in  a  manner  that  makes  it  almost  impossible 
for  one  who  is  in  a  hurry  to  make  any  progress;  and  without 
any  warning  people  will  turn  at  right  angles  and  stop  in 
front  of  a  show  window,  and  it  is  only  by  exercising  the 
greatest  of  care  that  one  avoids  bumping  into  them.  We 
do  not  believe  necessarily  in  military  training,  but  no  one 
has  ever  instructed  us  how  to  move  along  in  public  places, 
especially  on  the  busy  street,  in  a  manner  that  will  prevent 
irritation  on  the  part  of  our  fellow  men. 

There  are  some  people  who  believe  that  some  particular 
accident  will  befall  them  at  some  time.  They  know  that 
they  will  end  by  being  killed  in  some  peculiar  manner.  I 
know  of  one  man  who  has  the  slight  hallucination  that 
possibly  one  of  the  greatest  dangers  to  avoid  is  getting  in 
and  out  of  an  elevator,  and  he  never  steps  in  or  out 
without  doing  so  on  the  bound.  It  would  be  almost  im- 
possible to  catch  him  should  the  elevator  slip,  as  he  has 
trained  himself  to  be  so  alert  in  that  particular  maneuver 
that  he  is  sure  of  clearing  himself  either  way  in  any  instance. 

That  is  very  good  training,  indeed,  but  should  we  de- 


ALERTNESS  125 

velop  our  alertness  in  every  respect  we  would  find  that 
we  would  accomplish  a  great  deal  more,  and  that  we  would 
be  a  great  deal  safer  as  far  as  accidents  are  concerned. 

Going  back  to  college  days,  alertness  amounts  to  en- 
thusiasm. Certain  students  will  sit  listening  with  the  great- 
est of  eagerness  to  every  word  that  the  professor  has  to  say. 
They  will  take  notes;  make  references;  and  in  every  possible 
manner  post  themselves  on  each  subject  sufficiently  to  master 
it,  as  far  as  that  is  possible  in  college  days,  and  come  out 
with  the  best  of  marks  when  graduating. 

While  this  first  step  is  very  commendable,  it  must  be 
followed  up  by  alertness  in  business.  The  osteopath  who 
goes  to  his  office  to  meet  his  appointments  in  a  half-hearted 
manner,  with  cold  hands  and  careless  dress,  sometimes  not 
sufficiently  nourished,  will  lose  just  that  much  in  his  prac- 
tice, as  everything  works  in  ratio  and  proportion  in  almost 
every  instance.  I  have  been  treated  by  osteopaths,  who 
were  in  no  physical  condition  themselves,  and  upon  thor- 
ough investigation,  have  found  that  they  were  not  living  up 
to  a  standard,  in  the  way  of  taking  care  of  themselves,  that 
would  keep  them  physically  fit,  so  that  their  patients  would 
feel  that  they  were  examples  of  their  work. 

Enthusiasm  and  alertness  are  not  synonymous,  but  go 
very  well  hand  in  hand,  and  the  man  who  is  absolutely  en- 
thusiastic in  his  work  will  be  more  likely  to  be  alert  than  the 
man  who  is  jogging  along  from  day  to  day,  just  putting  in 
tune. 

It  makes  the  heart  glad  to  see  a  person  so  alert  that 
when  you  speak  to  him  he  catches  everything  you  say  and 
is,  apparently,  eager  for  more.  We  can  train  ourselves  to 
become  so  alert  that  we  will  be  interesting  to  the  other 
person,  in  that  we  are  good  listeners. 

From  a  diagnostic  standpoint,  we  reach  the  climax  of 


126  PRACTICAL  VISIONS 

the  value  of  alertness  in  sizing  up  our  patient,  so  to  speak, 
and  noting  as  rapidly  as  possible  all  the  various  objective 
symptoms,  and  correlating  them  in  such  a  manner  that 
we  feel  that  we  have  a  good  understanding  of  the  patient 
from  all  standpoints  before  we  have  finished  our  examina- 
tion and  given  our  diagnosis.  The  manner  in  which  a  pa- 
tient walks,  talks,  listens  to  what  you  are  saying;  the  con- 
dition of  his  skin ;  the  cold  and  warm  areas  over  the  body;  the 
way  his  feet  and  hands  hang  when  sitting  or  walking;  the 
way  he  sits  down;  the  way  he  gets  up;  the  way  he  holds  his 
head  and  his  chest;  all  of  these  little  things  put  together  mean 
everything  to  an  observant  physician. 

Some  doctors  think  that  to  make  a  great  impression  on 
a  patient  they  must  tell  him  that  they  don't  care  to  know 
what  his  symptoms  are,  or  what  any  one  else's  opinion  is, 
but  that  they  will  make  their  own  diagnosis.  I  am  of  the 
opinion  that  it  is  just  as  well  to  listen  a  little  bit  to  what  the 
patient  tells  you.  You  need  not  let  on  that  you  are  giving 
it  any  particular  weight,  but  just  listen  a  bit  while  you  are 
working  away  and  making  your  own  examination.  You 
may  be  surprised  to  find  that  there  are  certain  things  a 
patient  knows  that  you  never  could  find  out,  even  if  you  are 
psychically  inclined,  and  sometimes  a  hint  or  suggestion 
dropped  by  a  patient,  whose  experience  from  a  subjective 
standpoint  has  undoubtedly  been  greater  than  yours,  who 
have  observed  him  simply  from  an  objective  standpoint, 
may  be  most  timely  and  of  value  to  you.  It  is  not  neces- 
sary to  sit  down  and  let  the  patient  talk  to  you  for  ten,  fif- 
teen, or  twenty  minutes,  in  a  roundabout  manner,  but 
listen  in  a  bit  while  you  are  considering  the  case  and  add 
that  knowledge  to  your  own,  and  you  will  be  benefited 
thereby. 

There  is  also  a  great  advantage  in  being  alert  along 


ALERTNESS  127 

another  line,  and  that  is  remembering  what  the  patient 
has  told  you  and  what  you  found  at  the  time  of  first  examina- 
tion. There  are  many  patients  who  will  recall  certain 
statements  you  have  made,  and  who  may  even  remind  you 
that  you  said  "so  and  so."  Alertness  alone  will  assist  you 
in  bringing  back  from  your  memory's  storehouse  these  var- 
ious points  of  interest,  which  may  mean  either  keeping  or 
losing  your  patient. 

For  some  reason  or  other,  a  physician  is  supposed  to 
be  a  walking  encyclopedia  along  therapeutical  lines.  No 
organic  disturbance  or  name  given  to  any  particular  disease 
is,  in  the  mind  of  the  patient,  sufficient  reason  for  his  physi- 
cian not  being  posted  on  it.  They  love  to  quote  some  term 
that  has  been  given  to  some  disease,  possibly  of  a  neighbor, 
or  even  to  their  own  condition,  by  some  specialist,  who  has 
made  a  previous  examination,  just  to  see  if  you  understand 
what  is  meant  by  that  particular  diagnosis  or  terminology. 
The  physician  who  reads  various  journals,  keeps  himself 
posted  from  day  to  day,  and,  most  of  all,  studies  anatomy 
sufficiently  to  remember  details,  is  the  man  who  will  shine 
in  case  of  an  emergency. 

Just  the  other  day  I  heard  a  hearty  discussion  among 
three  doctors,  regarding  an  X-ray  plate,  as  to  which  was  the 
radius  and  which  was  the  ulna.  They  were  all  well-posted 
doctors,  but  in  the  stress  of  emergency  and  excitement, 
with  the  patient  waiting  to  have  the  bone  set,  the  discus- 
sion arose  as  to  which  bone  was  broken.  Eventually,  Gray's 
anatomy  was  brought  out  to  decide  who  was  correct. 

Alertness  in  the  study  of  anatomy  will  associate  ideas 
and  relationships  to  such  an  extent  that  you  will  seldom  be 
caught  in  case  of  an  emergency;  that  you  will  be  able  to 
make  statements  and  stand  by  them,  and  be  found  correct 
when  the  true  test  is  applied. 


128  PRACTICAL  VISIONS 

Alertness  will  bring  to  you  a  good  physical  condition, 
in  that  alertness  is  associated  with  better  vasomotor  tone; 
clearer  thinking,  from  a  mental  standpoint;  also  better  co- 
ordination in  the  great  central  nervous  mechanism. 


CHAPTER  XIV 


"DO  IT  NOW" 


(9) 


CHAPTER  XIV. 

"DO  IT  NOW" 

Slogans  are  invaluable.  Laconic  expressions  have 
won  battles,  when  emphasized  by  the  right  man. 

The  best  illustration  that  I  can  give  of  specific  osteop- 
athy is  that  of  a  good  horseman,  with  tight  reins,  getting 
the  most  out  of  his  steed.  Whether  a  horse  understands 
psychology  or  not,  I  believe  there  is  possibly  no  more  know- 
ing animal  than  the  horse,  and  about  the  best  test  of  horse- 
manship is  demonstrated  when  a  man  or  woman  takes  hold 
of  the  reins. 

Now,  the  osteopathic  application  is  this:  The  confi- 
dence that  a  doctor  has  in  his  own  ability,  backed  up  by  a 
knowledge  of  anatomy,  physiology,  pathology,  and  so  forth, 
is  the  keynote  of  his  success.  Included  in  this  proposition 
is  accurate  diagnosis,  founded  on  a  knowledge  of  the  basic 
principles  of  the  subjects  that  we  have  referred  to  above. 
A  patient  knows  in  an  instant  whether  the  physician  has  a 
clear  understanding  of  his  case  in  his  mind,  and  the  mo- 
ment a  physician  hesitates,  or  looks  puzzled,  that  moment  a 
patient  loses  his  confidence  in  his  physician,  just  the  same 
as  a  horse  will  knowingly  "act  up"  or  possibly  run  away 
with  the  rider  who  has  not  sufficient  confidence  in  handling 
or  driving. 

Well  do  I  remember  when  the  expression  "Do  It  Now" 
came  out  in  the  papers.  There  are  all  kinds  of  applications, 
and  perverted  ideas  may  have  arisen  from  this  short  slogan, 
in  that  a  robber,  thug  or  criminal  might  make  application 
of  the  motto,  but  for  a  man  or  woman  with  a  sound  mind 
and  a  sound  body,  I  know  of  no  single  motto  that  is  of  more 
significance.  It  applies  to  a  physician  in  his  work  in  every 

—131— 


132  PRACTICAL  VISIONS 

phase,  except  the  surgical.  Any  case  that  is  surgical  should 
be  considered  osteopathically  first.  "Try  Osteopathy 
First"  is  a  motto  we  have  used  for  some  time. 

In  handling  clinic  cases,  where  corrections  are  to  be 
made,  we  do  not  wait  to  relax  muscles,  but  immediately 
proceed  to  make  corrections,  and  the  more  rapidly  we  make 
the  corrections,  the  better  the  results.  If  there  are  three  or 
four  lumbar  lesions,  or  even  a  lower  thoracic,  and  the  child 
has  infantile  paralysis  and  withering  of  one  or  both  legs,  we 
at  once  commence  adjustment  in  these  chronic  cases,  stim- 
ulate the  vasomotors,  and  increase  the  nerve  impulses  that 
control  the  circulation  down  the  limbs.  No  massage  or 
muscle  technic  will  have  any  particular  effect.  We  must 
hold  a  tight  rein.  We  must  "do  it  now."  We  must  get 
results  as  quickly  as  possible.  The  nerve  centers  that  are 
not  properly  supplied  with  blood,  and  drained  by  veins  and 
lymph  channels,  will  sooner  or  later  become  so  affected  that 
they  will  lose  their  connection  with  the  great  central  nervous 
system,  that  formerly,  in  normal  conditions,  held  a  tight 
rein  over  them. 

The  same  proposition  holds  throughout  the  entire 
body.  The  central  nervous  system  controls  the  reins  to  ev- 
ery muscle  and  organ  throughout  the  entire  body,  and  when 
lesions  exist,  certain  nerve  centers  are  cut  off,  so  to  speak, 
in  that  they  lack  a  normal  impulse  function.  We  must  so 
adjust  the  human  body  that  the  circulation  will  be  restored, 
the  nerve  cells  again  resume  a  normal  condition,  and  the 
afferents  and  efferents  handle  the  situation  as  formerly. 

Again,  we  have  a  demonstration  of  a  tight  rein  in  the 
vasomotors  that  control  the  circulation  throughout  the  en- 
tire body,  singly  and  collectively.  There  are  certain  spe- 
cific vasomotor  centers;  there  are  also  general  vasomotor 
centers.  It  is  more  like  driving  horses  in  tandem,  in  that 


"Do  IT  Now"  133 

all  of  the  reins  must  be  tense  and  each  horse  feel  the  thrill  of 
the  tension  of  the  driver  who  holds  the  reins  in  his  hands. 
It  is  this  peculiar  normal  tension  throughout  the  entire  body 
that  gives  tone  to  the  muscles,  ligaments  and  organs,  and 
regulates  the  circulation.  Lack  of  tone,  or  a  loosening  of 
the  reins,  will  not  only  mean  vascular  disorders,  venous  sta- 
sis, ptotic  conditions,  and  lymphatic  blockage,  but  there  will 
also  be  a  loss  of  muscle  tone  and  of  general  nerve  tone, 
bringing  about  lassitude  and  a  chain  of  symptoms  that  follow 
a  system  which  has  lost  its  general  tone. 

The  expression  "Do  It  Now"  is  a  stimulus,  and  is  of 
great  value  to  an  osteopath  in  his  treatment  rooms.  In- 
stead of  standing  and  talking  to  a  patient,  take  hold  of  him, 
make  your  corrections,  and  let  him  know  that  you  are  there 
for  business;  that  you  are  anxious  for  his  speedy  recovery; 
that  you  are  also  anxious  to  know  his  subjective  symptoms, 
as  well  as  the  objective  symptoms;  that  you  do  not  intend 
to  leave  a  stone  unturned  in  bringing  about  recovery  that 
will  make  him  almost  equal  to  what  he  was  before  the  acci- 
dent, injury,  or  dietetic  error  that  brought  about  the  func- 
tional and  organic  disturbances. 

There  seems  to  be  so  much  hesitancy  in  the  world.  It 
takes  us  so  long  to  get  down  to  business.  We  ask  a  man 
for  an  interview;  we  spend  sufficient  time  in  approaching 
the  subject  to  have  expressed  ourselves  in  a  frank  manner 
and  received  a  reply. 

We  waste  time  on  the  telephone  when  we  should  train 
ourselves  to  express  ourselves  in  a  way  that  would  corre- 
spond with  records  that  are  made,  where  each  word,  sentence 
and  paragraph  is  thoroughly  considered  before  being  given 
out  for  recording. 

"Do  It  Now"  seems  to  be  synonymous  with  Doctor 
Still's  famous  expression  "Find  It,  Fix  It,  and  Leave  It 


134  PRACTICAL  VISIONS 

Alone."  There  are  those  who  think  that  Dr.  Still  was 
possibly  too  specific,  or  that  he  did  not  intend  that  his  dis- 
ciples should  practice  his  principles  and  treat  in  the  same 
way  that  he  did,  but  I  am  of  the  opinion  that  nothing  would 
please  the  Old  Doctor  more  than  for  each  student  so  thor- 
oughly to  have  mastered  the  subject  of  osteopathy,  that 
every  diagnosis  would  be  founded  upon  such  a  knowledge  of 
applied  anatomy  as  comes  only  through  the  deepest  study 
and  research.  It  was  comparatively  easy,  in  the  last  few 
years,  for  Dr.  A.  T.  Still  to  make  a  diagnosis  almost  in  an 
instant,  but  remember  that  back  through  all  the  years,  he 
spent  unnumbered  hours  working  up  to  a  point  where  the 
body  was  to  him  like  a  machine,  all  of  whose  parts  were 
thoroughly  understood. 

Some  of  our  men  are  good  students;  others  do  not  spend 
very  much  time  in  a  year  going  over  their  texts.  When 
they  once  get  through  college,  they  feel  that  the  next  thing 
in  life  is  to  make  a  living  and  save  up  money,  or  rather,  save 
up  for  those  who  come  along  and  want  them  to  invest.  There 
are  few  osteopaths  who  could  not  have  almost  everything 
they  desire  if  they  would  lock  the  door  to  speculators  and 
agents  of  all  kinds. 

Act  on  this  advice.  Do  it  now  and  see  how  it  works, 
but  be  sure  that  you  do  it  now  and  get  the  good  out  of  it. 
It  will  stimulate  your  vasomotors,  tone  your  thermogenic 
centers  and  increase  the  impulses  coming  from  a  nerve  with 
unusual  functioning  branches,  possibly  more  numerous  than 
any  physician  has  ever  comprehended — the  pneumogastric. 
Let  us  be  greater  students  of  applied  subjects.  "Do  It 
Now." 


CHAPTER  XV 


AIR  CASTLES 


CHAPTER  XV. 

AIR  CASTLES 

Every  year  we  receive  a  number  of  letters  from  various* 
parts  of  the  country,  in  which  confidential  matter  is  dis- 
cussed, usually  referring  to  some  "air  castle,"  which,  if 
materialized,  would  be  a  wonderful  proposition.  In  a  ma- 
jority of  the  instances,  I  could  readily  state  that  they  are 
practical,  and  could  be  developed  to  such  an  extent  that 
they  would  be  for  the  betterment  of  humanity. 

Almost  invariably  these  well-thought-out  schemes  and 
mentally  conceived  "air  castles"  fail  to  be  erected  from  a 
substantial  standpoint.  Whether  any  idea  is  lost  in  this 
world,  or  whether  some  one  else  picks  up  the  same  idea, 
in  some  telepathic  way,  and  carries  it  on  to  a  perfect  con- 
clusion, we  are  not  able  to  say.  But  I  am  strongly  of  the 
opinion  that  thoughts  create  vibrations,  that  thought  waves 
are  never  lost,  and  that  the  more  stable  the  thought,  that  is, 
the  more  practical,  the  better  it  will  carry,  in  that  the  vi- 
brations will  be  more  perfect.  We  have  all  had  experiences 
of  a  telepathic  nature.  I  have  never  yet  seen  a  person  who 
has  not,  supposedly  at  least,  influenced  the  mind  of  some  dis- 
tant friend  or  relative.  These  things  are  common,  every 
day,  occurrences.  But  when  a  man  with  supposedly  sound 
judgment  works  out  a  scheme  whereby  humanity  may  be 
benefited,  and,  for  some  lack  of  judgment  or  ripe  experience, 
fails  to  carry  out  his  idea  to  a  conclusive  end,  we  are  at  a 
loss  to  know  whether  it  is  the  fault  of  the  person,  or  whether 
it  is  some  congenital  error,  or  hereditary  diathesis  that  in- 
terferes with  the  workings  of  the  great  central  nervous  sys- 
tem that  is  supposed  so  to  harmonize  ideas  and  thoughts 
that  hi  the  perfect  correlation  and  co-ordination  there  will 

—137— 


138  PRACTICAL  VISIONS 

come  out  a  logical  reasoning,  founded  upon  a  safe  and  sound 
hypothesis. 

True  it  is  that  some  minds  are  of  an  inventive  turn — 
some  men  are  geniuses  by  birth — but  with  the  great  mental 
capacity  possessed  by  every  sane  man,  it  boils  down  to  a 
point  of  concentration  and  systematic,  conclusive,  mental 
exercise,  whereby  a  person  will  follow  through,  analytically 
and  logically,  any  new  thought  or  line  of  reasoning  that,  ap- 
parently at  least,  has  a  different  turn  to  it  than  any  express- 
ion that  has  heretofore  been  given. 

The  same  point  applies  to  research  work.  We  have 
referred  to  students  going  through  college,  wherein  they 
were  absolutely  positive  that  at  some  future  date  they 
would  do  research  work  along  a  certain  line  that  would 
startle  the  world.  So  confident  are  they  in  college  even 
at  the  present  time,  that  the  world  will  be  better  in  a  great 
many  respects  for  their  having  lived,  and  that  therapy  will 
have  broadened  to  some  extent  at  least  by  their  research 
findings,  that  it  is  almost  beyond  a  question  of  doubt  with 
them;  but  as  they  reach  a  point  in  their  studies  where  they 
find  that  the  great  world  of  humanity  is  but  a  seething  mass 
of  thoughts,  emanating  from  minds  that  throw  out  and 
reflect  ideas  from  almost  every  conceivable  angle,  they  be- 
come alarmed  and  wonder  if  some  one  else  has  not  thought 
of  that  same  idea  before.  This  throws  them  off  their  track, 
and  their  giving  up  is  absolutely  wrong. 

Take  up  your  work,  build  your  "air  castles,"  carry 
them  through,  even  if  some  one  else  has  done  the  same 
thing,  and  nine  times  out  of  ten  you  will  find  that  in  the 
process  of  mental  development  you  will  have  reached  some 
phase  or  stage  in  the  game  that  is  utterly  different  from  that 
of  any  other  person's  reasonings.  It  is  impossible  for  any 
two  human  intellects  to  handle  the  same  ideas  and  express 
them  in  absolutely  the  same  manner. 


AIR  CASTLES  139 

In  order  to  make  a  success  in  any  line  of  work  we  ab- 
solutely must  have  enthusiasm.  Oftentimes  a  person  is 
accused  of  being  over-exhilarated,  or  carrying  on  to  the 
extreme,  but  when  it  comes  down  to  a  fine  point,  is  it  not 
true  that  this  same  order  of  enthusiasm  carries  a  thing  over 
in  almost  every  instance? 

Osteopathically,  we  are  taught  that  we  should  exag- 
gerate the  lesion  in  order  to  make  normal  articular  restora- 
tion. However  true  this  may  be,  I  find  that  the  man  or 
woman  who  puts  his  or  her  whole  spirit  and  energy  into  any 
particular  line  of  work,  as  long  as  it  is  along  the  right  line, 
is  the  man  or  woman  who  will  command  attention  and  ac- 
complish things. 

It  is  absolutely  essential  in  the  advertising  line  to  write 
more  or  less  startling  advertisements,  in  order  to  attract  the 
attention  of  people.  Any  ordinary  advertisement,  or  any 
poorly-written  advertisement,  will  never  catch  the  eye  of 
the  person  who  rustles  through  the  leaves  of  a  magazine 
today.  It  has  been  stated  that  Gladstone  always  looked 
through  the  advertising  section  of  American  magazines 
first  of  all.  He  intimated  that  the  brains  of  the  country, 
in  the  line  of  advertisement  writers,  had  so  epitomized 
and  summarized  in  a  concentrated  form  the  ideas  that 
they  wished  to  put  across,  that  it  was  a  pleasure  to  read 
their  productions. 

One  of  the  best  practices  a  business  man  could  possibly 
have,  in  the  way  of  mental  training  along  the  line  of  elimina- 
tion of  superfluous  adjectives  and  other  words,  is  to  spend 
a  year  or  two  in  the  department  where  telegrams,  letter- 
grams, cablegrams,  daygrams,  and  radiograms  are  issued. 
In  a  year's  time  he  will  find  out  just  what  words  he  can 
leave  out  without  altering  to  any  extent  the  meaning  of  a 
sentence  or  paragraph. 


140  PRACTICAL  VISIONS 

The  most  interesting  lectures  I  ever  heard  were  given 
in  Denver  twenty-four  years  ago,  by  a  man  who  stood  on 
the  platform  in  a  theater  each  Sunday  morning  and  talked 
on  subjects  from  a  popular  standpoint  Those  who  heard 
him  agreed  that  he  was  the  most  concise,  laconic,  and  spe- 
cific sentence  framer  that  ever  spoke  on  an  American  plat- 
form. His  lecture  on  "Books"  was  a  classic,  written  like  a 
telegram — every  word  eliminated  that  was  not  necessary 
in  the  make-up  of  the  scaffold  that  held  up  his  great  idea. 

Dream  your  dreams;  work  out  original  ideas;  but  never 
let  them  drop  until  you  have  conclusively  demonstrated  to 
yourself  that  you  are  on  either  the  right  or  the  wrong  track, 
and  if  on  the  right  track,  never  give  up  until  you  have  build- 
ed  well  upon  a  mental  picture;  until  you  have  builded  well 
upon  what  was  once  only  a  vision  or  a  dream. 


CHAPTER  XVI 


GETTING  THE 
PRACTICAL  VISION 


CHAPTER  XVI. 

GETTING  THE  PRACTICAL  VISION 

Some  might  say  that  they  would  not  care  to  live  the 
life  of  an  Edison,  as  he  does  not  accept  invitations  to  ban- 
quets which  are  given  in  his  honor,  and  confines  himself 
almost  entirely  to  his  laboratory,  even  on  his  birthdays. 
But  we  find  that  in  order  to  accomplish  anything  great 
in  this  world  we  must  give  our  particular  work  the  greatest 
of  attention. 

Some  one  visiting  Europe,  standing  by  the  tomb  of 
Napoleon  Bonaparte,  paused  for  a  moment  and  said  to  a 
friend,  "How  still  he  lies!"  His  mind  had  been  wandering 
back  over  the  history  of  this  great  man  and  his  many  activi- 
ties; the  early  hours  at  which  he  arose  in  order  to  do  real 
thinking  and  strategic  planning,  and  when  he  summed  up 
all  of  his  review  of  that  great  and  active  man,  he  made  the 
remark  just  quoted. 

Although  handicapped  physically,  there  are  those 
who  have  accomplished  great  things.  It  is  impossible  for 
every  one  to  feel  as  active  as  the  darkey  fleeing  from  a  sup- 
posed ghost,  and  exclaiming  when  a  rabbit  started  in  the 
trail  ahead  of  him,  "Get  out  of  my  way,  so  that  I  can  run 
faster."  We  read  so  much  nowadays  about  getting  the 
vision.  There  are  those  who  know  what  vision  really  is, 
and  there  are  those  who  will  never  know.  Dr.  A.  T.  Still 
had  a  vision  which  was  practical  in  nature  and  we  are  profit- 
ing by  it.  There  are  millions  who  go  down  without  ever 
being  known.  We  are  all  endowed  with  minds  and  we 
develop  such  a  small  part  of  our  grey  matter  that  the  great 
majority  of  brain  cells  remain  inactive,  even  when  we  pass 
away  at  a  goodly  age. 

—143— 


144  PRACTICAL  VISIONS 

We  find  osteopaths  who  have  been  practicing  a  decade, 
and  who  have  never  made  themselves  known  in  any  manner 
outside  of  their  local  communities.  We  also  have  osteo- 
paths who  have  been  practicing  two  decades,  and  who  have 
never  contributed  anything  in  particular  to  their  science 
and  who  have  never  worked  out  any  new  ideas  in  the  way  of 
developing  the  greatest  science  that  has  ever  been  discovered 
along  therapeutical  lines. 

We  know  of  osteopaths  who  have  been  practicing  twenty 
years  or  more  who  are  not  treating  any  more  patients  at  the 
present  time  than  they  did  ten  or  fifteen  years  ago,  and  they 
are  giving  the  same  length  of  treatment,  or  even  longer, 
than  they  did  many  years  ago.  They  are  still  without 
typewriters  in  their  offices;  they  are  still  writing  longhand 
letters,  and  very  few  at  that.  The  same  text  books  that 
they  had  at  school  are  still  on  their  shelves;  no  new  editions 
have  appeared  on  certain  subjects,  and  very  few  osteopathic 
books  are  to  be  seen.  They  write  no  articles  for  our  maga- 
zines; they  prepare  no  papers  or  addresses  for  our  conven- 
tions; they  simply  drift  along,  devoting  their  entire  time  to 
their  work,  and  the  preparation  for  a  rainy  day.  They  do 
not  know  what  it  means  to  study  two  or  three  hours  a  day, 
on  the  average;  they  do  not  know  what  it  means  to  do 
research  work,  or  to  keep  in  touch  with  the  various  subjects 
common  to  all  schools;  they  hold  no  clinics — they  are  prac- 
tically "dead  numbers." 

On  the  other  hand,  we  have  in  our  profession  men  who 
go  out  to  practice;  men  who  are  full  of  good  ideas;  become 
active  in  the  various  osteopathic  societies;  give  new  thoughts 
and  ideas;  do  research  work;  improve  upon  their  methods 
of  treating,  and  are  of  great  benefit  to  the  profession  as  a 
whole  in  many  ways. 

There  is  no  osteopath  living  who  cannot  make  himself 


GETTING  THE  PRACTICAL  VISION  145 

more  or  less  famous  if  he  will  but  concentrate  on  some  one 
phase  of  our  work — do  research  work,  and  develop  certain 
lines  of  thought — and  present  it  in  a  way  that  would  be  ap- 
preciated and  of  value  to  the  profession  as  a  whole. 

We  are  endowed  with  brains,  and  we  should  use  them. 
We  are  going  to  feel  the  need  of  greater  activity  very  short- 
ly; in  fact,  we  are  feeling  it  just  now.  We  are  lying  down 
on  the  job  to  the  extent  that  rival  schools,  although  of  low- 
er type,  are  outnumbering  us,  in  many  instances,  and  unless 
we  get  the  proper  vision  and  become  wide  awake,  we  are 
going  to  find  that  within  a  few  years  we  have  lost  the  pearl 
of  great  price. 

We  will  consider  free  clinics  for  a  few  minutes,  and  will 
prove  that  a  free  clinic  is  of  greater  value  to  you,  in  more 
ways  than  one,  than  you  have  ever  dreamed  of.  Since  we 
established  our  clinic  six  years  ago  we  have  been  more  active 
and  have  found  occasion  to  do  a  greater  amount  of  work, 
both  in  general  practice  and  in  contributing  along  various 
lines  to  the  profession,  of  articles,  drawings  and  research 
work,  than  we  ever  had  done  before.  While  we  treat  as 
many  as  forty  at  one  clinic  meeting,  we  find  that  it  does  not 
take  any  of  our  strength,  but  gives  us  a  thrill  and  puts  us  in 
the  best  condition  to  carry  on  our  regular  work  for  the  re- 
mainder of  the  day.  It  is  very  easy  to  treat  forty  clinics 
in  one  hour  and  twenty  minutes.  We  can  demonstrate  at 
any  time,  and  it  can  be  done  by  others.  It  is  also  possible 
to  treat  as  many  as  eighty-six  patients  a  day,  and  not  be 
too  greatly  fatigued. 

After  all,  it  is  the  vision  that  counts,  and  the  thrill  that 
goes  with  your  work.  Back  of  this  is  a  great  love  for  your 
work,  based  upon  most  careful  and  continuous  study  of  the 
human  body  in  all  of  its  various  phases. 

We  have  received  from  the  profession,  a  few  replies  to 

(10) 


146  PRACTICAL  VISIONS 

letters  in  which  we  have  asked  the  doctors  to  establish  clinics, 
with  answers  along  this  line:  "We  have  our  regular  prac- 
tice ;  it  takes  all  of  our  time,  and  we  have  not  sufficient 
strength  to  conduct  clinics  as  well. "  Evidently  these  doctors, 
although  endowed  with  good  minds  and  capable  of  con- 
ducting good  practices,  are  so  self-centered  that  they  are 
devoting  their  entire  time  and  attention  to  work  that  will 
put  them  in  good  shape  for  a  rainy  day.  Why  not  think  of 
the  poor  unfortunates  who  have  not  the  mentality  that 
these  doctors  have,  who  are  struggling  along,  handicapped 
by  physical  disabilities,  and  who  will  possibly  never  know 
what  it  is  to  be  in  a  position  where  they  will  be  able  to 
make  more  than  a  bare  living? 

To  me  the  greatest  pleasure  in  life  is  my  clinic.  I  enjoy 
every  minute  of  it,  and  it  is  no  trouble  for  me  to  arise  in  the 
morning  at  six,  or  before,  and  be  in  readiness  for  the  clinic, 
which  commences  about  eight  o'clock.  It  is  a  pleasure,  in- 
deed, to  see  the  little  ones  congregate  and  look  up  to  us  for 
strength  and  health.  It  is  a  thrilling  experience,  and  by  the 
time  the  clinic  is  over,  we  feel  as  if  we  could  conquer  the 
whole  world.  In  the  first  place,  we  must  have  love  for  the 
children  and  a  desire  to  do  them  good,  and  it  is  possible  to 
receive  additional  strength  when  we  are  doing  good  and  when 
we  are  putting  our  whole  soul  into  our  work. 

Regarding  regular  practice,  it  is  also  the  same  proposi- 
tion. We  must  have  a  vision  that  is  greater  than  that  en- 
tertained by  the  majority;  we  must  figure  out  on  each  morn- 
ing we  start  our  work  in  a  large  city  that  there  are  at  least 
five  thousand  persons  that  day  who  should  require  our  ser- 
vices, and  the  few  we  treat  are  only  a  small  percentage  of  the 
great  number  who  really  need  treatment.  With  this  little 
vision  in  mind,  we  go  about  our  work  joyfully,  and  treat 
as  many  as  we  possibly  can,  realizing  that  the  majority 


GETTING  THE  PRACTICAL  VISION  147 

of  the  suffering  people  can  not  be  handled  because  there  are 
not  osteopaths  enough.  It  is  a  matter  of  enthusiasm  which 
may  be  included  with  vision,  and  no  osteopath  should  go 
into  his  office  in  the  morning  feeling  dull  or  tired.  We  are 
called  upon  for  greater  mental  activity  than  any  doctor  in 
any  other  school.  We  are  asked  questions  that  are  not 
asked  those  doctors  whose  habits  are  to  "look  wise  and 
keep  silent."  We  are  out  to  educate  the  world  along  osteo- 
pathic  lines;  we  are  ready  to  give  advice  and  to  answer 
questions. 

In  order  to  prepare  oneself  for  a  good  day's  work,  one 
must  have  a  proper  amount  of  sleep,  that  is,  regular  sleep. 
If  you  really  want  to  have  a  large  practice  you  must  do  a 
little  sacrificing  along  the  lines  of  pleasure.  You  must  get 
to  bed  early  and  keep  yourself  perfectly  fit,  so  that  your 
mind  will  be  active,  and  that  you  will  remember  each  pa- 
tient's symptoms,  that  you  will  be  quick  in  comprehending 
a  patient's  trouble,  and  be  ready  to  give  proper  diagnosis. 
This  calls  for  extreme  mental  alertness  and  physical  fitness, 
but  all  this  may  be  easily  acquired  if  we  are  more  anxious  to 
have  it  than  anything  else.  We  may  have  to  forego  euchre 
parties,  dances,  and  entertainments  of  various  kinds,  as  well 
as  social  functions,  but  is  it  not  worth  it?  The  few  years 
that  we  are  in  active  practice  we  should  devote  our  entire 
time  and  energy  to  the  one  thing.  So  many  of  our  osteo- 
paths think  that  the  social  side  will  be  of  great  advantage 
to  them,  and  we  have  a  few  osteopaths  who  pride  themselves 
upon  their  personality  to  the  extent  that  they  claim  they  can 
hold  a  practice  from  that  standpoint  better  than  from  that 
of  study  and  research  work. 

Now,  it  is  a  question  as  to  whether  you  really  want  to 
do  more  work,  better  work,  and  have  better  technic;  and 
if  you  do,  we  will  tell  you  in  a  few  sentences  how  to  go  about 


148  PRACTICAL  VISIONS 

it.  At  least,  I  am  one  of  the  kind  who  try  to  practice  what 
they  preach,  and  those  who  have  visited  me  will  say  that  I 
do  not  make  statements  which  cannot  be  demonstrated  at 
any  time  or  upon  any  occasion.  My  wife  tells  me  that 
she  has  never  known  or  heard  of  any  one  who  has  devoted 
more  time,  since  she  has  known  me,  which  is  twenty-three 
years,  than  I  have  in  study  and  research  work.  Fortunately 
she  is  of  a  nature  that  makes  it  a  pleasure  to  work,  as  she  is 
perfectly  willing  to  forego  the  various  social  stunts  in  order 
that  I  may  carry  out  the  work  which  I  am  trying  to  do. 
Although  studying  on  the  average  of  three  hours  almost 
every  day  in  the  year,  outside  of  holidays,  I  find  that  I  am 
still  behind  in  keeping  in  perfect  touch  with  all  of  the  various 
phases  of  our  work,  but  I  also  find  that  this  constant  study 
and  time  put  into  keeping  posted,  has  been  the  very  thing 
that  has  made  me  active  in  my  work  and  served  as  a  stimulus 
for  greater  achievement  along  the  line  of  office  work. 

You  must  go  to  your  office  in  the  morning  very  fresh; 
you  must  be  ready  to  give  the  first  patient  as  much  attention 
as  the  second,  and  you  must  also  be  as  fresh  at  the  end  of 
the  day  as  you  are  when  you  start  in  the  morning.  This 
calls  for  reserve  energy  and  a  buoyancy  of  spirit  and  a  light- 
ness of  heart,  as  our  work  in  a  way  is  depressing  unless  we 
keep  overstocked  with  strength  and  energy.  We  have  pur- 
posely kept  away  from  entering  into  the  specialties  for  the 
reason  that  we  believe  that  some  one  must  remain  active  in 
the  general  practice  in  each  locality,  in  order  that  osteopathy 
may  be  perpetuated.  After  all,  it  is  the  general  practitioner 
who  is  going  to  perpetuate  osteopathy.  The  specialists 
have  entered  a  field  wherein  they  are  not,  technically  speak- 
ing, looked  up  to  as  practitioners  of  osteopathy.  Did  you 
ever  think  of  that?  While  we  do  not  blame  them  for  entering 
the  field  of  specialists  for  several  reasons,  we  do  state  that 


GETTING  THE  PRACTICAL  VISION  149 

osteopathy  will  be  perpetuated  almost  entirely  by  those 
who  are  remaining  in  general  practice.  So,  you  who  are 
in  general  practice  are  really  the  standard  bearers  of  oste- 
opathy. 

It  will  not  hurt  you  to  study  a  little  psychology,  or  to 
read  books  like  those  that  are  published  at  the  present  time 
giving  one  a  course  along  the  line  of  mental  training — books 
on  Power,  Master  Keys,  and  brochures  that  are  printed 
along  psychological  lines.  I  have  found  them  a  most  won- 
derful benefit  to  me.  We  must  realize  that  we  are  human 
dynamos,  and  that  we  have  energy  within  us,  if  properly 
stirred  through  mental  activity,  to  accomplish  almost  any- 
thing which  we  may  desire.  If  we  do  not  feel  at  the  end  of 
a  year  that  we  are  better  posted,  are  better  physicians,  and 
have  better  technic,  and  can  handle  patients  more  skillfully, 
than  the  year  previous,  we  are  not  accomplishing  what  we 
should,  and  we  are  not  living  up  to  the  viewpoint  we  thought 
we  had  when  we  talked  about  vision.  An  osteopath  who 
treats  only  ten  or  twelve  a  day  lacks  system.  He  has  time 
to  burn ;  he  is  not  giving  himself  proper  credit.  The  man  who 
treats  twenty  a  day  is  not  doing  half  what  he  should  do;  he 
also  has  time  that  he  is  wasting.  The  man  who  treats  forty 
a  day  still  has  abundance  of  time.  It  is  all  a  matter  of  sys- 
tem, and  a  matter  of  knowing  how  to  do  things. 

Dr.  Reid's  course  on  "Personal  Efficiency,"  I  under- 
stand, is  great.  I  enjoy  reading  his  articles  and  I  know  of 
many  who  have  been  wonderfully  benefited  by  them.  Years 
ago  he  was  a  partner  of  mine,  when  we  practiced  in  Wor- 
cester, Mass.,  but  in  those  days  we  did  not  treat  the  number 
that  we  do  at  the  present  time,  and  specialties  were  practi- 
cally unknown.  Allow  me  to  be  a  bit  personal  when  I  an- 
swer a  few  questions.  By  the  way,  I  have  a  very  heavy  mail, 
and  my  average  correspondence  is  twenty  letters  a  day. 


150  PRACTICAL  VISIONS 

This  necessitates,  of  course,  a  dictaphone,  into  which  I  talk 
in  the  evenings,  after  studying  for  an  hour  or  two.  It  is  a 
very  easy  matter  to  talk  into  a  dictaphone  and  take  the 
cylinders  to  the  office  in  the  morning  and  have  them  typed 
off  by  a  good  stenographer.  We  have  two  typewriters, 
Underwoods,  and  two  stenographers  all  the  time.  One  acts 
as  office  attendant,  and  by  the  way  is  a  graduate  nurse.  She 
answers  certain  personal  letters,  which  are  handed  over  to 
her,  on  her  own  machine  at  her  desk  in  the  main  office. 
So,  you  see,  we  are  able  to  write  these  many  letters;  also 
dictate  technical  articles,  as  well  as  articles  for  popular 
magazines,  and  at  least  edit  one  journal  on  the  side,  besides 
writing  an  occasional  book,  as  we  have  done  in  the  past  few 
years,  not  mentioning  the  more  than  three  hundred  colored 
plates  and  drawings  in  black  and  white  which  have  been 
put  out  in  the  last  twelve  years. 

With  those  who  think  it  is  impossible  to  treat  seventy  or 
eighty  patients  a  day,  we  will  not  discuss  the  matter.  We 
will  simply  say  we  know  it  is  impossible  for  them  to  do  it 
with  their  viewpoint  and  limited  vision.  We  want  men  in 
our  profession  who  will  have  still  greater  vision  and  who  will 
raise  the  standard  of  osteopathy,  both  as  to  technic  and  as 
to  details  and  research  work,  and  bring  our  profession  to  the 
forefront  as  it  has  never  been  brought  before. 


CHAPTER  XVII 


SPECIFIC  TREATMENT 


CHAPTER  XVII. 

SPECIFIC  TREATMENT 

Some  years  ago  I  heard  Sir  William  Osier  lecture  on  a 
medical  subject,  and  he  referred  to  the  amount  of  medicine 
given  by  the  young  medical  practitioner,  just  commencing 
practice,  and  showed  how  each  year  the  dosage  was  lessened, 
until  after  a  physician  had  practiced  medicine  for  twenty 
years  or  more,  he  was  ready  to  state  that  there  were  few 
known  specifics  and  that  a  sufficient  quantity  of  medicine 
for  a  large  practice  could  be  carried  in  his  vest  pocket. 
While  he  did  not  name  the  four  specifics,  the  majority  of 
people  know  what  they  are. 

Now,  specific  osteopathy  is  an  entirely  different  propo- 
sition, in  that  we  do  not  eradicate,  as  years  go  by,  the  spe- 
cial treatment  given  to  certain  nerve  centers;  but  we  do 
treat  more  specifically,  and  we  don't  spend  the  great  length 
of  time  in  making  our  findings  and  in  trying  to  relieve  all 
symptoms  at  once,  as  the  young  practitioner  is  most  liable 
to  do. 

It  takes  time  to  familiarize  oneself  with  the  human 
anatomy  and  give  specific  treatment,  and  we  do  not  blame 
the  young  practitioner  the  first  year  for  giving  fairly  long 
treatment;  but  when  a  man  practices  for  ten  years,  or  even 
five  years,  and  still  gives  half  hour  treatments,  just  then  we 
put  that  practitioner  down  as  one  who  is  not  progressing, 
and  one  who  is  not  familiarizing  himself  with  the  specific 
nerve  centers  that  control  the  various  organs  and  tissues 
in  the  human  body. 

Just  wherein  does  specific  treatment  differ  from  general 
treatment?  It  is  true  that  we  treat  the  same  nerve  centers 
in  specific  treatment  as  we  do  in  general  treatment,  but  we 

—153— 


154  PRACTICAL  VISIONS 

don't  go  over  and  over  these  same  nerve  centers,  relaxing 
muscles  and  teasing  out  the  tissue  contractures,  but  we 
apply  sufficient  force  to  get  articular  motion  in  a  manner 
that  gives,  at  the  same  time,  vasomotor  stimulation. 

In  order  to  make  this  perfectly  clear,  we  will  give  a  few 
examples  and  show  wherein  a  specific  treatment  is  of  more 
value  to  a  patient  than  a  general  treatment,  and  wherein 
we  can  make  better  headway  by  giving  specific  treatment 
and  restore  the  patient  in  a  shorter  period  of  time. 

We  will  take,  for  instance,  a  case  of  migraine,  so  com- 
monly found,  and  so  noticeably  presented,  as  a  rule,  to  a 
young  physician.  He  is  of  the  opinion  that  it  can  be  cured 
at  once.  He  gives  a  thorough  cervical  treatment,  as  well 
as  general  treatment,  and  he  is  so  positive  that  the  migraine 
condition  will  pass  away  that  he  is  very  much  surprised 
to  find,  in  some  instances,  that  it  is  a  reflex  disturbance, 
and  that  a  general  systemic  harmony  must  exist  before  it  is 
relieved.  It  may  be  necessary  to  reduce  an  acidosis,  pos- 
sibly from  an  innominate  lesion.  There  may  be  flat  feet, 
changing  the  axis  of  the  spine.  The  pneumogastric  with 
its  various  ramifications  may  be  involved.  There  may  be 
hepatic  congestion  or  splenic  enlargement;  renal  or  supra- 
renal disturbance,  and  last,  but  not  least,  an  ovarian  colic 
accompanying  the  migraine,  or  a  pelvic  congestion  involving 
not  only  the  various  organs  and  tissues,  but  the  lymphatic 
nodes,  in  their  relation  to  the  mesenteric  vessels. 

The  young  physician  will  possibly  visualize  a  patient's 
condition  from  a  general  standpoint,  focusing  his  attention 
on  the  cervical  lesion  in  order  to  relieve  the  disturbance 
higher  up.  He  may  or  he  may  not  realize  that  the  great 
vasomotor  and  splanchnic  centers  are  involved,  in  that  the 
upper  thoracic,  or  even  middle  thoracic,  lesions  may  be 
the  causative  factor,  through  the  semilunar  ganglion,  or 
there  may  be  a  reflected  disturbance  in  the  hypogastric 


SPECIFIC  TREATMENT  155 

plexus  or  pelvic  plexus,  through  a  tilted  sacrum  or  an  an- 
terior lumbar  condition. 

Take  another  case.  There  may  simply  be  neuritis 
in  the  shoulders  or  down  the  arm.  Only  a  careful  observer, 
who  has  been  trained  along  the  lines  of  lymphatic  terminal 
drainage,  would  notice  that  peculiar  edematouus  condition 
back  of  the  clavicles,  at  the  sternal  end,  and  realize  that  the 
neuritis  may  possibly  be  due  primarily  to  a  specific  verte- 
bral lesion,  and,  secondarily,  to  lymphatic  blockage  that 
exists  even  in  the  spaces  around  the  nerve  cells.  It  is  only 
of  recent  date  that  we  have  found,  through  research  work, 
that  there  may  be  a  lymphatic  blockage  within  the  sheath 
of  a  nerve,  and  that  until  restoration  is  made,  in  the  way 
of  lymphatic  drainage,  it  will  be  quite  impossible  to  reduce 
the  neuritic  condition. 

A  third  illustration.  There  may  be  a  swollen  or  ede- 
matous  condition  of  the  ankles.  This  may  not  appear  to 
the  patient  as  being  of  any  significance.  The  young  doctor 
may  feel  that  it  is  simply  a  lack  of  drainage,  that  there  may 
be  a  little  enteroptosis,  or  possibly  a  pelvic  congestion;  and 
he  may  not  connect  up  the  fact  that  the  edematous  area 
corresponds  with  the  blockage  in  the  popliteal  spaces,  as 
well  as  the  inguinal  nodes,  and  that  the  lymph  channels 
may  be  blocked  to  such  an  extent  that  the  receptaculum 
chyli  is  overloaded.  There  may  also  be  a  secondary  con- 
dition, from  the  fact  that  the  hepatic  nodes,  as  well  as  the 
gastric  and  splenic,  are  likewise  enlarged,  and  that  the  entire 
lymphatic  drainage  system  is  blocked  in  the  region  of  the 
diaphragm. 

Correcting  the  vertebral  lesions  will  be  of  no  particular 
permanent  value  if  there  is  a  sacral  tilt,  or  if  one  of  the  in- 
nominates  is  subluxated  in  its  relation  to  the  sacrum.  There 
may  also  be  a  lymph  blockage  at  the  terminals.  This  must 
be  determined,  as  in  no  case,  unless  there  is  terminal  lym- 


156  PRACTICAL  VISIONS 

phatic  drainage,  can  we  expect  to  have  perfect  drainage 
from  the  ankles,  for  the  lymph,  in  part  at  least,  must  event- 
ually reach  the  thoracic  duct  and  through  that  the  left  sub- 
clavian  vein. 

We  are  of  the  opinion,  however,  as  frequently  expressed 
in  the  Journal  of  the  International  Society  for  Lymphatic 
Research,  that  a  great  deal  of  the  lymph  is  taken  up  by  the 
veins;  otherwise,  the  mechanical  arrangement  for  the  hand- 
ling of  the  lymph  is  out  of  all  proportion  to  what  has  been 
described  in  the  various  texts  on  physiology. 

We  want  the  young  practitioner  to  get  the  vision  of 
making  accurate  diagnoses  as  early  as  possible.  We  want 
him  to  consider  the  entire  body  as  one  machine,  that  all  of 
the  component  parts  are  interrelated,  not  only  from  a  vas- 
cular standpoint,  but  from  the  standpoint  of  nerve  con- 
nections as  well. 

In  order  to  give  specific  treatment,  then,  it  will  become 
necessary  during  the  first  two  or  three  adjustments,  for 
us  to  correct  those  specific  centers  which  have  control  of 
the  most  strategic  points.  To  give  a  general  treatment 
and  churn  up  the  entire  circulation  of  the  body,  as  well  as 
the  various  secretions,  is  contra-indicated.  We  must  se- 
cure drainage  at  the  most  strategic  points,  and  this  can  only 
be  done  by  observing  in  particular  the  ebb  and  flow  of  the 
lymphatic  circulation.  By  watching  the  edematous  areas 
in  various  parts  of  the  body,  we  may  very  readily  be  able 
to  determine  what  part  of  the  body  is  blocked,  from  a  lym- 
phatic standpoint,  and  what  areas  are  lacking  in  the  lymph 
fluid. 

Our  great  fault  has  been  in  trying  to  give  systemic 
treatment  in  every  instance,  when  specific  treatment,  at 
specific  nerve  centers,  is  of  far  greater  value.  It  is  also  a 
less  tax  on  the  patient,  and  a  more  speedy  recovery  follows, 
for  we  have  not,  in  any  instance,  tired  our  patient. 


CHAPTER  XVIII 


DIAGNOSIS 


CHAPTER  XVIII. 

DIAGNOSIS 

The  standard  by  which  a  physician  is  judged  is  usually 
one  of  diagnosis.  When  a  physician  has  the  reputation  of 
being  a  diagnostician,  he  seems  to  stand  well  in  the  com- 
munity;  that  is,  if  he  lives  up  to  that  reputation. 

Most  physicians  pride  themselves  on  being  good  at 
diagnosing.  As  the  human  machine  is  constructed  prac- 
tically the  same  in  all  instances,  in  that  we  have  a  certain 
number  of  bones,  muscles,  nerves,  blood  vessels,  and  so 
forth,  the  laity  do  not  understand  why  it  is  such  a  difficult 
task  for  a  physician  to  make  an  accurate  diagnosis  in  any 
and  ah1  instances.  It  is  only  after  a  student  has  spent  two 
or  more  years  in  a  therapeutic  college  that  the  idea  dawns 
upon  him  that,  while  there'  are  a  certain  number  of  bones, 
muscles,  and  so  forth,  in  the  human  anatomy,  yet  there  is 
a  possibility  of  disturbances  and  disorders  attacking  var- 
ious tissues  in  various  places,  including  not  only  the  frame- 
work, from  an  osseous  standpoint,  but  pressure  directly  or 
indirectly  through  contracture  produced  by  the  various 
measures  that  are  not  only  unnatural,  but  unexpected  in 
many  instances. 

When  a  physician  realizes  that  his  diagnosis  depends 
upon  a  thousand  and  one  conditions,  so  to  speak,  in  that 
not  only  the  chemistry  of  the  human  body  must  be  de- 
termined, from  a  secretory  and  metabolic  standpoint,  but 
the  relative  position  of  the  organs  in  their  various  regions; 
the  varying  quantity  of  the  fluids  in  the  body;  the  tone, 
or  lack  of  tone,  in  the  muscles;  the  degree  of  anemia  that 
so  often  exists;  the  activity  or  inactivity  of  the  ductless 
glands;  the  variation  in  the  endocrines;  and  so  on  through 

—159— 


160  PRACTICAL  VISIONS 

the  entire  list  of  organs  and  tissues  that  functionate  in  some 
manner  or  other  continuously  throughout  the  entire  sys- 
tem; he  feels  his  position  keenly. 

It  is  unwise  in  any  instance  to  give  a  systemic  treatment 
of  any  nature  until  an  absolute  routine  examination  at  least 
has  been  given.  This  does  not  account  for  special  tests  and 
examinations  that  may  be  indicated  in  each  particular  case. 

In  the  group  clinics  that  are  being  conducted  all  over 
the  country,  following  along  the  line  of  the  original  clinic 
in  Rochester,  physicians  are  becoming  more  accurate,  sys- 
tematic, and  complete,  if  we  may  speak  in  that  manner,  in 
the  examination  of  their  patients. 

The  old  school  practitioner,  especially  in  the  rural  dis- 
tricts, was  supposedly  an  authority  on  every  known  ail- 
ment of  the  human  body,  even  to  the  condition  of  the  teeth — 
whether  or  not  they  should  be  extracted  or  treated  in  any 
manner  whatsoever.  He  was  not  only  considered  to  be  a 
specialist  in  gynecology,  but  in  everything  from  obstetrics 
to  infectious  diseases.  We  now  refer  to  these  instances 
almost  with  amusement,  and  we  are  pleased  to  know  that 
the  general  practitioner,  when  confronted  by  a  condition 
that  does  not  manifest  itself  plainly  to  him,  secures  the  ad- 
vice of  some  specialist  in  a  group  clinic,  or  in  private  prac- 
tice, who  has  devoted  his  entire  time  and  attention  along 
that  particular  line. 

Postmortem  findings,  in  connection  with  some  of  our 
great  hospitals,  prove  that  diagnosis  has  been  made  incor- 
rectly in  a  great  percentage  of  cases.  Now,  this  being  true, 
wherein  does  the  fault  lie? 

We  understand  that  in  order  to  be  able  to  make  a  proper 
diagnosis  a  physician  must  not  only  be  familiar  with  his 
anatomy,  physiology,  pathology,  and  so  forth,  but  he  must 
also  be  a  master  mechanic,  in  that  the  human  body  is  a  ma- 


DIAGNOSIS  161 

chine.  The  study  of  applied  anatomy  is  one  of  the  most 
essential,  not  only  surgically  as  we  have  a  number  of  text 
books  on  surgical  applied  anatomy;  but  applied  anatomy 
from  a  mechanical  standpoint  as  well.  This  is  not  taught 
in  the  medical  colleges.  It  is  taught  only  in  the  osteopathic 
colleges.  The  application  of  each  phase  brought  out,  in 
that  the  relations  of  the  various  tissues  are  taught  from  an 
applied  standpoint,  can  be  figured  out  only  as  we  consider 
that  the  body  is  a  machine,  and  that  structural  changes 
take  place,  through  accidents,  stress,  and  outside  forces 
that  are  not  taught  in  the  older  schools. 

In  order  to  be  a  good  diagnostician,  it  is  not  enough, 
therefore,  to  have  a  complete  knowledge  of  the  human 
body,  from  a  chemical  standpoint,  in  relation  to  the  various 
secretions,  endocrines,  and  so  forth.  We  must  also  be 
able  to  determine  upon  examination  wherein  structural 
changes  have  caused  perversion,  not  only  in  the  nerve  tracts, 
but  also  in  the  blood  vessels  and  various  tissues  and  organs 
that  make  up  the  composite  whole. 

It  will  all  depend  upon  the  viewpoint  the  practitioner 
has,  as  to  his  ability  to  diagnose  a  case  after  thorough  ex- 
amination. If  his  viewpoint  is  distorted  to  the  extent 
that  he  is  not  familiar  with  the  physiological  movements 
of  the  spine,  he  will  not  be  able  to  make  a  complete  diag- 
nosis in  any  instance.  If,  for  any  reason,  he  has  not  been 
trained  as  to  the  effect  of  disturbance  on  various  nerve 
centers,  in  their  relation  to  organs  and  tissues,  he  will  not 
be  able  to  diagnose  accurately  in  any  instance. 

Until  Dr.  A.  T.  Still  discovered  the  principles  and 
practice  of  osteopathy,  there  never  had  been  a  complete 
diagnosis  made  in  any  instance  in  the  world's  history.  The 
ideas  brought  out  by  Dr.  A.  T.  Still  absolutely  revolution- 
ized the  therapeutic  reckonings.  The  older  method  of 

(ii) 


162  PRACTICAL  VISIONS 

diagnosing  from  symptoms,  subjective  and  objective,  did 
not  include  the  most  important  phase  from  a  diagnostic 
standpoint.  The  osteopathic  physician,  who  goes  through 
the  college  and  fails  to  grasp  the  idea  relative  to  applied 
anatomy,  will  not  be  able  to  make  the  same  diagnosis  as 
the  student  who  has  a  broader  concept,  and  who  realizes 
the  significance  of  pathological  findings  in  their  relation  to 
the  tissues  from  an  applied  anatomy  standpoint.  All 
through  the  entire  course,  the  applied  anatomy  viewpoint 
must  be  kept  in  mind.  Even  in  the  dissecting  room,  as 
well  as  in  the  technic  department,  the  student  must  ever 
be  on  the  alert  to  determine  the  applied  viewpoint  in  every 
instance.  It  will  be  necessary  to  combine  all  of  the  various 
sources  of  information  in  relation  to  the  human  body  when 
making  the  diagnosis  of  some  bodily  perversion.  Every 
pathological  phase  must  be  deduced  back  to  the  point  where 
the  primary  lesion  existed.  The  reasonings  made  by  an 
osteopath  include  the  framework  of  the  body  and  its  struc- 
tural arrangement,  from  both  a  normal  and  an  abnormal 
viewpoint. 

The  reason  some  of  our  younger  practitioners  fail  to 
get  the  proper  viewpoint  in  making  the  diagnosis,  is  because 
they  cannot  collectively  assimilate  the  various  workings  of 
the  human  anatomy  in  all  of  its  various  phases  aud  realize 
that  the  disturbances  manifested,  when  making  an  examina- 
tion, are  due,  in  most  cases,  to  a  systemic  disturbance  that 
includes  the  entire  central  nervous  system  and  its  various 
connections. 

No  organic  disease  can  exist  without  proportionately 
affecting  the  entire  body.  No  one  nerve  can  be  irritated 
or  disturbed  to  any  extent,  without  disturbing  the  harmony 
of  the  entire  system.  There  is  no  such  a  thing  as  a  local  or- 
ganic disturbance.  We  have  to  consider,  in  each  instance, 


DIAGNOSIS  163 

the  various  reflex  propositions.  We  have  to  remember  the 
relation  of  the  various  nerve  branches  to  the  central  nervous 
system.  We  must  consider  the  various  nerve  tracts  that 
carry  different  impulses;  the  different  motor  tracts  that 
control  and  supply  certain  areas;  and,  at  the  same  time,  are 
under  the  great  central  nervous  system.  We  must  keep  in 
mind  the  various  areas  of  the  body  that  are  controlled  by 
certain  nerves  through  certain  nerve  centers;  the  distribu- 
tion of  the  vasomotors;  the  motor,  and  the  sensory  impulses; 
and,  above  all,  the  fact  that  all  of  the  local  centers  are  sec- 
ondary to  the  great  controlling  center  located  in  the  brain. 
We  must  keep  in  mind  the  various  circulations;  the  arterial 
supply;  the  venous  return  circulation;  and  the  lymphatic 
circulation  that  permeates  almost  all  tissues.  It  is  imposs- 
ible to  be  too  careful  about  making  a  diagnosis.  The  more 
accurate  the  diagnosis,  the  more  readily  we  will  understand 
the  case  and  secure  results. 

It  may  take  the  young  physician  a  little  time  to  get 
his  bearings  and  become  familiar  with  certain  phases,  es- 
pecially where  there  is  more  or  less  metabolic  disturbance, 
but  in  time  the  young  practitioner  will  begin  to  realize  that 
each  case  is  individual  in  itself,  in  that  a  different  diagnosis 
will  have  to  be  made  than  in  a  previous  case  of  a  similar 
nature.  No  two  cases  are  alike.  The  symptoms  in  one 
case  never  tally  with  those  in  another,  in  every  detail.  The 
various  combinations  that  go  to  make  up  a  diagnosis  are 
so  numerous  that  it  would  be  impossible  to  compile  in  any 
book  all  of  the  various  manifestations  that  are  shown  in 
all  diseased  conditions. 

If  the  young  graduate  is  well  posted  in  all  of  the  var- 
ious subjects,  it  will  be  no  trouble,  in  a  comparatively  short 
time,  to  work  out,  from  symptoms,  a  diagnosis  that  will 
be  sufficiently  accurate  to  enable  him  to  apply  proper  tech- 


164  PRACTICAL  VISIONS 

nic.  It  requires  continuous  study  in  order  to  keep  in  mind 
applied  anatomy,  and  especially  pathology,  as  based  upon 
the  reasonings  from  an  osteopathic  viewpoint.  No  book 
has  yet  been  written,  on  certain  subjects  that  are  most  im- 
portant to  the  osteopath.  There  is  a  vast  field  for  those 
who  are  inclined  towards  research  work,  to  give  in  detail 
the  findings  that  are  so  much  needed  at  the  present  time. 
We  are,  as  yet,  a  new  school.  We  have  not,  as  yet,  got  all 
of  our  bearings;  but,  in  time,  we  trust  that  we  will  be  able 
to  secure  a  text  book  that  will  give  the  students  a  better 
knowledge  of  how  to  make  a  diagnosis  than  is  contained  in 
the  text  books  of  the  older  schools. 

Students  often  realize,  while  going  through  college,  the 
need  of  better  text  books,  that  is,  from  an  osteopathic  stand- 
point, and  oftentimes  they  feel  that  some  day  they  will  be 
able  to  get  out  something  along  that  line;  but,  when  enter- 
ing upon  practice  in  a  new  field,  their  minds  seem  to  dwell 
more  upon  establishing  a  practice  and  they  soon  drift  away 
from  their  original  ideas  and  determinations,  and  we  find 
very  few  who  take  sufficient  interest  in  their  work  and 
studies  to  do  sufficient  research  work  that  will  be  given  to 
their  fellow  men.  It  does  seem,  with  all  of  the  findings  that 
are  recorded  in  the  various  books  in  the  country,  collected 
through  all  the  ages  past,  especially  during  more  recent  years, 
that  we  should  be  given  sufficient  information  to  enable  us 
to  go  ahead  and  work  out  in  detail  certain  conditions  upon 
which  we  could  make  a  more  accurate  diagnosis. 

There  are  very  few  in  any  profession  who  are  really 
studious,  and  who  can  do  original  work  to  the  extent  that 
they  can  give  something  new  to  their  fellow-men.  How- 
ever, there  are  a  sufficient  number  of  students  who  could 
do  this  if  they  would  apply  themselves,  and  we  are  hoping 
that  in  the  next  few  years  a  number  of  our  osteopaths  will 


DIAGNOSIS  165 

get  together  and  get  out  textbooks  along  the  line  of  path- 
ology, applied  anatomy,  neurology,  and  so  forth.  We  have 
a  field  in  osteopathy  that  is  second  to  none.  We  have  a 
greater  opportunity  to  do  research  work  than  has  the  older 
school.  We  have  a  broader  viewpoint;  we  have  an  applied 
anatomy  vision  that  is  not  embodied  in  the  course  of  any 
of  the  older  schools.  We  have,  as  a  rule,  a  more  thorough 
knowledge  of  the  human  anatomy,  in  that  we  spend  more 
hours  and  study  more  carefully  the  details  found  in  the 
human  body.  Upon  this  working  basis,  it  should  be  no 
great  struggle  for  us  to  bring  out  new  phases  relative  to 
diagnosis  that  will  enable  us  to  make  a  diagnosis  that  is 
most  complete  in  every  respect. 

While  we  are  not  able,  at  all  times,  to  discern  certain 
internal  conditions,  we  should  in  time  evolve  principles  that 
will  enable  us  to  make  more  accurate  diagnoses  in  every 
instance. 

The  principles  of  osteopathy  are  true  to  nature;  true 
to  the  bodily  mechanism;  and  the  findings  that  are  worked 
out  from  an  applied  anatomy  standpoint,  as  well  as  from 
a  pathological  viewpoint,  backed  up  by  structural  defects 
and  tissue  disturbances,  enable  us  to  visualize  conditions 
that  cannot  be  worked  out  from  any  other  viewpoint. 

Every  year  that  you  practice,  if  you  are  conscientious 
and  studious,  you  will  be  able  to  make  a  better  diagnosis 
than  you  did  the  year  previous  in  similar  cases;  and  after 
ten  years'  practice,  you  will  have  a  viewpoint  that  will 
be  so  far  ahead  of  the  one  you  had  a  decade  previous,  that 
you  will  wonder  why  you  did  not  understand  certain  condi- 
tions at  that  time. 

We  learn  by  experience.  We  also  can  learn  by  study 
and  research.  No  man  makes  a  success  in  any  particular 
line  of  work  unless  he  gives  it  thought  and  attention.  Pride 


166  PRACTICAL  VISIONS 

yourself  on  making  clear  diagnoses,  and  never  feel  that  you 
have  mastered  the  subject  entirely.  It  is  a  life's  work,  and 
a  pleasant  one,  if  you  have  put  your  whole  soul  into  your 
work.  It  takes  daily  enthusiasm  in  order  to  accomplish 
anything. 

After  a  person  loses  his  enthusiasm,  his  work  is  never  up 
to  par.  Enthusiasm  carries  us  along  from  day  to  day,  and 
makes  work  a  pleasure,  where  otherwise  it  would  be  drudgery. 


CHAPTER  XIX 


BE  SPECIFIC 


CHAPTER  XIX. 

BE  SPECIFIC 

PeaDut  vendors,  I  dare  say,  are  as  sincere  and  do  as 
much  thinking,  according  to  their  limited  cerebral  capacity, 
and  lie  awake  as  many  hours  at  night,  as  some  of  the  great- 
est statesmen  and  business  men  who  rule  the  affairs  of  the 
world. 

It  is  always  amusing  to  me  to  have  some  unsuccessful 
or  limited  person  in  any  walk  of  life  step  up  to  some  success- 
ful business  magnate  and  try  to  tell  him  how  to  do  things. 
It  is  like  fellows  on  the  program  of  the  American  Osteopathic 
Association  telling  about  the  wonderful  things,  from  a  theo- 
retical standpoint,  which  can  be  accomplished,  and  how  to 
do  this  and  how  to  do  that,  and  all  the  rest  of  the  year  in 
their  home  practice  and  by  the  bedside  you  hear  nothing  in 
particular  of  their  work. 

We  have  not  lived  up  to  our  promise,  as  practitioners 
of  osteopathy.  We  have  not  kept  the  practical  vision  that 
Dr.  A.  T.  Still  gave  us.  We  have  not  followed  his  motto 
or  the  example  that  he  set.  We  have  given  patients  the 
impression  ah1  over  the  country  that  we  make  appointments 
one -half  hour  or  possibly  one-quarter  hour  apart,  and  that 
they  must  come  at  a  certain  time  in  order  to  receive  full 
time  treatment  This  is  where  we  have  fallen  down,  and 
we  have  no  occasion  to  blame  any  other  school  if  we  are  the 
losers. 

Would  a  Barker,  of  London,  England,  give  his  patients 
the  impression  that  he  had  to  manipulate  or  adjust  an  ankle 
or  knee,  or  some  part  of  the  spinal  column,  and  take  a  cer- 
tain length  of  time  for  it? 

Would  Reese,  of  Youngstown,  put  in  a  certain  length 

—169— 


170  PRACTICAL  VISIONS 

of  time  in  order  that  the  patient  would  feel  that  he  had  re- 
ceived his  money's  worth.  I  want  to  say  here  that  the 
appointment  sheet  idea  is  all  wrong,  and  that  when  we 
make  appointments  ahead  so  that  patients  may  come  at  a 
certain  time,  we  are  giving  them  the  impression  that  they 
are  to  be  given  a  certain  length  of  treatment,  and  they  will 
naturally  expect  it.  In  other  words,  the  lady  patients,  for 
instance,  arrange  ahead  of  time,  so  that  they  can  practically 
take  a  half  day  off  in  order  to  have  their  treatment  and  get 
back  home.  The  proper  way  to  go  about  this  is  from  a  psy- 
chological standpoint.  We  all  know  that  in  business  houses, 
department  stores,  and  even  in  our  practice,  there  are  cer- 
tain times  and  days  when  people  come  in  droves,  and  that 
we  must  not  have  such  registered  routine  that  we  cannot 
adjust  ourselves  to  the  condition.  I  know  of  osteopaths 
who,  when  called  over  the  phone  to  make  certain  appoint- 
ments, say,  "No,  I  am  booked  up  for  the  day.  You  will 
have  to  come  tomorrow. "  Now,  let  me  tell  you  right  here, 
and  I  am  a  frank  speaker  and  speak  according  to  what  I 
put  into  practise,  that  when  a  patient  calls  up  and  is  in  a 
hurry  for  treatment  I  give  him  the  time  that  suits  him. 
Suppose  you  have  twelve  or  fourteen  in  your  office  at  one 
time;  they  can  easily  be  cleared  out  in  one  hour,  and  by 
using  a  little  tact,  you  can  get  certain  patients  to  wait  for 
a  few  minutes  by  telling  them  that  some  one  is  going  to 
catch  a  train,  or  is  in  a  great  hurry  to  fill  some  appointment, 
and  you  will  have  no  difficulty  at  certain  times  in  handling 
the  overflow  which  is  liable  to  happen  one  or  more  times 
every  week. 

You  have  followed  more  along  the  line  of  the  dentist, 
who  makes  appointments  for  a  definite  length  of  time,  at  a 
definile  period  in  the  day.  This  is  absolutely  unnecessary 
and  all  wrong. 


BE  SPECIFIC  171 

Throw  your  appointment  sheet  to  the  wind,  and  have 
an  office  girl  who  knows  your  work  so  well,  and  who  is  so 
well  posted  on  just  what  you  can  do  and  what  you  cannot 
do,  that  she  will  make  the  appointments  without  any  sheet 
at  all  and  will  never  get  you  overloaded  at  any  one  time. 

Now,  I  am  speaking  from  experience.  We  started  out 
with  the  ordinary  sheets,  which  we  put  up  ourselves.  They 
held  names  of  about  twenty-five  patients  a  day.  We  en- 
larged this  until  we  had  a  sheet  that  would  hold  sixty  a  day. 
We  finally  threw  the  sheets  away,  and  although  all  of  the 
hours  and  divisions  of  hours  were  on  these  sheets,  we  do 
not  use  them  at  the  present  time;  only  one  large  sheet  for 
putting  down  the  names  of  the  patients  as  they  come  in, 
also  recording  their  credit. 

When  a  patient  phones,  instead  of  saying  "Well,  let 
me  look  at  my  sheet  and  see  if  we  have  any  time, "  the  nurse 
says,  "What  time  do  you  want  to  come?  Could  you  come 
at  a  certain  hour?"  If  he  says,  "No,  I  would  rather  come 
so  and  so,"  she  says,  "All  right,  come  ahead.  The  Doctor 
will  take  you  as  an  emergency  case. " 

Now,  boys,  I  am,  as  I  said  before,  talking  from  exper- 
ience. With  five  treatment  rooms,  we  find  that  we  are  short 
at  times  for  space,  but  by  a  little  strategy,  that  is,  treating 
those  who  will  get  out  in  quick  time,  or  some  child,  or  busi- 
ness man  who  is  in  a  hurry,  we  seldom  have  any  difficulty 
in  keeping  our  office  clear.  We  have  no  large  waiting  room, 
and  were  I  to  arrange  an  office  again,  I  would  have  no  wait- 
ing room,  any  more  than  along  the  hallway.  We  do  not 
want  patients  sitting  around.  We  want  to  put  them  in  a 
room,  treat  them,  and  get  them  out;  we  do  not  want  pa- 
tients lying  around  after  treatment;  we  send  them  home, 
that  is,  the  ladies,  to  lie  down  and  rest  for  one  hour.  We 
never  allow  them  to  go  shopping  after  a  treatment.  They 


172  PRACTICAL  VISIONS 

must  go  straight  home.  The  men  can  do  as  they  please, 
as  our  treatments  are  exhilarating  in  nature  and  they  can 
work  all  the  harder  for  having  had  a  treatment.  You  see 
the  advantage  in  giving  short,  specific  treatment  is  that 
we  do  not  tire  our  patients.  They  do  not  feel  as  if  they 
would  like  to  lie  down  and  rest,  and  we  do  not  have  any 
trouble  from  having  the  ladies  block  the  rooms,  as  they 
are  told  as  soon  as  they  have  their  treatment,  that  they 
must  dress  and  go  home 

Regarding  examination,  we  seldom  treat  a  patient,  when 
we  examine  him, unless  he  is  suffering  in  someway;  but  the 
examination,  a  thorough  one,  must  come  first.  We  go 
over  the  lymphatics.  You  will  have  read  ere  this,  the  article 
in  the  A.  O  A.  JourLal  on  "How  to  Make  a  Lymphatic 
Examination, "  so  we  do  not  care  to  go  into  this  again.  It 
is  also  published  in  detail  in  Applied  Anatomy  of  the  Lym- 
phatics, which  is  being  read  by  a  great  number  of  the  pro- 
fession. After  making  the  lymphatic  examination,  we 
always  take  the  blood  pressure,  even  if  the  patient  has  had 
treatment  from  some  other  osteopath,  that  is,  a  traveling 
man  or  an  unsatisfied  patient,  which  by  the  way,  we  all 
have,  and  listen  well  to  the  heart  action  and  the  lungs,  and 
if  necessary  make  blood  tests,  if  there  is  any  tendency  towards 
anemia  or  any  pus  present  in  any  part  of  the  body,  indicated 
by  enlarged  lymph  nodes.  We  have  the  best  Leitz  micro- 
scope that  is  made;  also  blood  testing  apparatus,  as  well  as 
a  chemical  laboratory,  and  in  no  way  neglect  the  patient's 
condition,  and  yet  do  not  take  all  day  to  make  an  examina- 
tion. Be  so  alert  and  keen  in  your  work  that  you  will  sum 
up  the  patient's  condition  as  nearly  as  possible  in  the  short- 
est length  of  time.  Cut  out  the  talk,  and  work.  Get  down 
to  business,  and  don't  let  your  patient  talk  either,  other 
than  to  give  you  a  few  subjective  symptoms  that  you  may 


BE  SPECIFIC  173 

call  for.  State  definitely  that  you  find  so  and  so  recorded 
on  the  spine;  that  a  certain  injury  happened  a  certain  num. 
her  of  years  ago,  which  you  will  be  able  to  determine  after 
you  practice  a  few  years,  almost  specifically.  Tell  him  how 
he  fell,  and  about  how  long  he  was  laid  up,  and  the  symp- 
toms that  followed  the  fall,  and  so  forth.  This  can  all  be 
done  after  a  few  years  of  practice,  so  that  the  patient  will 
know  what  you  are  talking  about. 

After  the  examination,  hand  a  specimen  of  urine  and 
the  brief  slip,  upon  which  you  have  written  the  essential 
points,  to  the  nurse,  and  she  will  give  the  patient  a  time 
for  report,  diagnosis  and  prognosis,  on  the  next  day,  and  go 
to  your  next  patient.  All  this  need  not  take  more  than  a 
few  minutes'  time. 

Get  away  from  that  old  idea  of  having  to  ask  a  patient 
a  thousand  questions.  Be  able  to  read  the  patient  your- 
self, and  not  depend  on  what  the  patient  says,  as  he  may 
not  have  the  right  idea  of  his  case  at  all.  He  may  be  going 
by  what  some  doctor  told  him  at  some  previous  date.  Al- 
ways ask  the  patient  three  questions — "Have  you  ever  had 
an  operation?"  "Are  you  constipated?"  "Do  you  have 
headaches?"  These  three  will  give  you  a  better  line  on  the 
case  than  anything  else  you  may  ask,  as  far  as  we  know. 

When  the  patient  comes  in  for  treatment  and  you  go 
into  the  room,  do  not  sit  down  or  let  him  sit  down  and  start 
saying,  "Well,  how  do  you  feel  today?"  Simply  have  him 
jump  on  to  the  table,  and  if  he  will  not  lie  down,  and  wants 
to  talk,  tell  him  in  a  very  nice  way  to  do  so,  that  you  will 
listen  while  he  is  talking  and  at  the  same  time  start  in  giving 
such  a  good  specific  treatment  that  he  will  be  glad  to  hush 
up.  We  have  found  that  these  short  specific  treatments 
are  absolutely  best  for  patients  and  that  they  like  them. 
They  like  for  you  to  get  down  to  business  and  work. 


174  PRACTICAL  VISIONS 

If  they  start  talking  politics,  religion,  or  anything  else, 
or  ask  you  about  osteopathy,  tell  them  that  you  will  explain 
when  you  get  through,  and  when  you  get  through  they  will 
have  forgotten  it.  Do  not  forget,  though,  to  have  the  pa- 
tient get  a  booklet  on  osteopathy,  which  will  be  in  the  room, 
or  handed  to  him  by  the  nurse  as  he  goes  out.  They  can  do 
their  own  reading;  this  will  save  time,  and  the  literature 
which  is  published  at  the  present  day  is  much  better  worded 
than  anything  we  can  say. 

Save  your  breath.  It  means  energy;  keep  your  mouth 
open  only  to  inhale  more  air.  If  you  want  to  be  strong  and 
healthy  in  your  practice,  treat  with  your  mouth  open — not 
wide  open,  but  sufficiently  to  inhale  plenty  of  air.  I  have 
noticed  a  lot  of  osteopaths  who  hold  their  mouths  so  tight 
when  they  are  not  talking  that  they  have  insufficient  air. 
It  does  not  hurt  to  breathe  through  your  mouth  in  a  warm 
room  This  is  one  way  I  have  kept  well  all  of  these  years. 
There  is  another  way  which  I  will  tell  you  about  some  time. 
I  have  told  a  great  number  of  osteopaths  and  it  positively 
keeps  you  from  having  a  sore  and  sensitive  abdomen,  and 
the  typhoid  fever  that  so  many  of  our  boys  get;  as  well  as 
enteroptosis  through  their  backs  aching,  their  nerve  centers 
being  undertoned,  and  venous  stasis  in  certain  cases. 

Regarding  attire  in  the  treatment  room  I  wear  a  shirt- 
waist effect  the  year  round,  with  four  point  suspenders, 
and  simply  work  in  my  shirt  and  trousers.  As  soon  as  I  go 
into  a  room  I  pull  off  my  coat.  They  like  the  idea — getting 
down  to  business.  They  want  you  to  concentrate  your 
entire  time  and  energy  on  their  cases;  they  want  you  to 
remember  what  you  found  out  and  told  them  the  first  time 
you  examined  them.  Don't  forget  this.  Take  a  little 
private  special  memory  course  of  your  own,  and  be  sure  you 
remember  what  a  patient  has  said  and  what  you  have  told 


BE  SPECIFIC  175 

him.  This  is  of  vital  importance.  Start  your  treatment 
in  such  a  way  that  he  will  know  that  you  are  all  eyes  and 
ears  and  interest  in  his  case. 

While  we  are  doing  this  work,  let  us  devote  our  entire 
time  and  energy  to  it.  When  we  get  older  we  can  retire 
from  practice  and  think  of  something  else.  If  a  patient 
persists  in  talking,  say,  "Excuse  me,  but  the  lesion  that  I 
corrected  the  other  day  seems  to  be  a  little  better.  I  thought 
you  would  like  to  know,"  and  if  he  starts  talking  a  little 
later  on,  ask  him  how  that  symptom  he  referred  to  the  other 
day  has  been,  and  keep  his  mind  off  of  the  talking  point,  as 
much  as  you  possibly  can. 

Always  leave  your  patient  feeling  good.  As  soon  as  you 
notice  that  he  is  tired  or  droopy  in  any  instance,  quit  right 
then — absolutely  quit,  and  do  as  little  treating  as  possible 
when  the  patient  is  sitting  up  on  the  stool.  There  is  where 
you  tire  your  patient  out — fiddling  on  the  cervical  vertebrae 
with  the  patient  sitting  up.  It  is  liable  to  over-stimulate 
the  nerves  and  cause  either  nausea  or  fainting.  Get  away 
from  that.  Do  your  treating  while  the  patient  is  lying 
down,  except  a  very  small  amount  of  specific  treatment  in 
the  upper  dorsal,  with  patient  sitting  up. 


CHAPTER  XX 


"FORGET  IT" 


(12) 


CHAPTER  XX. 

"FORGET  IT" 

When  a  boy,  I  had  the  greatest  admiration  for  physi- 
cians. My  father's  home  seemed  to  be  a  hanging-out  place 
for  doctors.  My  father  should  have  been  a  surgeon.  Many 
a  time  he  has  assisted  in  emergency  cases.  He  has  nerves 
of  "steel."  Strange,  how  we  miss  our  callings  sometimes 
and  drift  away,  through  environment,  into  unexpected 
fields,  and  thereby  fail  to  give  to  the  world  what  was  nat- 
urally expected  of  us. 

In  later  years,  I  found  out  that  physicians  have  their 
weaknesses  also,  and  that  while  they  may  know  the  human 
body  to  a  greater  extent  than  any  living  professional  man 
outside  of  the  therapeutic  band,  yet  there  seems  to  be  an 
inherent  weakness,  or  lack  of  the  training  that  should  exist 
in  order  that  the  physician  may  be  capable  of  rounding  him- 
self out  sufficiently  on  all  sides. 

People  naturally  expect  a  physician  to  be  an  encyclo- 
pedia on  any  therapeutical  subject,  and,  undoubtedly,  they 
are  better  posted  on  one  theme  than  any  other  class  of  peo- 
ple, as  they  make  that  their  business;  but  we  find  that  doc- 
tors have  their  own  troubles,  and  that,  in  many  instances, 
they  are  incapable  of  self-control  sufficiently  to  throw  off 
matters  that  worry  them.  Consequently,  the  average 
length  of  life  of  a  physician  is  slightly  less  than  that  of  a 
business  man.  It  is  not  because  they  lack  knowledge  of  the 
physiological  activities  of  the  human  organism,  or  that  they 
do  not  know  how  to  combat  various  diseases  and  patho- 
logical conditions  in  the  majority  of  cases,  but  it  is  that 
element  of  "human  nature"  that,  by  the  way,  makes  the 

—179- 


180  PRACTICAL  VISIONS 

world  akin,  that  seems  to  "get"  a  physician  the  same  as 
any  other  person. 

A  young  doctor  starting  out  in  his  practice  will  often 
lie  awake  nights  worrying  over  his  cases.  Instead  of  giv- 
ing the  patient  the  very  best  that  he  has  in  him  at  the  time, 
and  dismissing  the  case  from  his  mind,  other  than  to  post 
up  on  the  disease  if  he  is  not  entirely  familiar  with  the  sub- 
ject, he  will  wonder  and  worry  to  the  extent  that  his  nerves 
will  almost  become  shattered  in  the  first  few  months  of  his 
practice.  Few  physicians  entirely  escape  this,  and  while 
it  may  be  true  that  the  more  sensitive  a  physician  is,  the 
greater  interest  he  will  show  in  his  patients,  and  the  more 
good  he  will  accomplish,  yet  a  physician  must  school  himself 
and  so  train  his  mind  that  he  will  not  be  drawn  into  this 
nervous  whirlpool  by  over- worry  and  anxiety. 

The  old  expression  "Lest  We  Forget,"  should  be 
changed  to  the  newer  expression  "Forget  It."  This  may 
appear  like  slang,  but  we  have  found  that  this  little  motto 
has  been  of  great  value  to  us  in  a  great  many  instances;  in 
fact,  from  a  psychological  standpoint,  almost  all  of  the 
trouble  existing  in  this  world  is  from  the  point  of  remem- 
brance. 

We  are  urged  in  school  to  study  history — the  rise  and 
downfall  of  nations,  especially  the  downfall  and  cause  of 
downfall.  We,  as  a  people,  are  more  or  less  fond  of  an- 
tiques. We  love  to  recall  those  good  old  days  when  certain 
things  existed.  We  are  constantly  saying,  "Bring  back 
those  good  times  that  we  had  years  ago,  and  we  will  be 
happy. " 

A  time  is  coming  when  we  will  live  in  the  future.  We 
will  so  dwell  on  the  future  that,  as  Ralph  Waldo  Trine  says, 
"Each  day  will  be  a  new  beginning."  We  will  simply 
use  the  accumulated  knowledge  that  has  been  registered  on 


"FORGET  IT"  181 

the  cerebral  cortex  to  aid  us  in  building  new  structures 
and  accomplishing  greater  things. 

There  is  no  reason  why  a  young  physician  should  not 
have  a  viewpoint  as  well  as  any  one  else.  The  mere  fact 
that  a  physician  is  supposedly  posted  in  anatomy  and  physi- 
ology, is  no  reason  why  we  should  suggest  that  he  has  not 
a  heart  in  him,  a  sensitive  nature  sometimes,  and  a  longing 
for  the  betterment  of  humanity.  If  the  college  student 
will  so  post  himself  while  going  through  school  that  he  will 
feel  that  he  is  master  of  each  subject,  it  will  be  an  easy  mat- 
ter for  him  to  apply  this  knowledge  when  starting  in  prac- 
tice, and  by  the  use  of  reference  books  and  the  latest  jour- 
nals, be  able  to  keep  abreast  of  the  times.  After  all,  no 
physician,  with  very  few  exceptions,  has  been  known  to 
make  a  tremendous  success  unless  he  has  been  sufficiently 
interested  to  keep  up  to  the  minute  in  everything  that  is 
going  on  in  the  therapeutic  world. 

All  feudal  wars,  community  disturbances,  duels,  trage- 
dies of  every  kind,  invariably  refer  back  to  some  time  when 
some  incident  has  happened  that  has  made  mental  im- 
pressions which,  through  recollection,  have  exaggerated 
themselves  sufficiently  to  deepen  the  nerve  tract  impression 
and  reflexly  disturb  the  thermogenic  and  vasomotor  centers 
sufficiently  to  arouse  agitation  in  the  cerebrospinal  mecha- 
nism. 

Physicians  are  looked  up  to  in  each  community  from  a 
respectful  standpoint,  providing  they  are  worthy  physi- 
cians, and  no  man  should  stand  higher  in  his  community 
than  a  physician.  His  ranking  is  near  to  that  of  a  minister 
at  least.  Therefore,  we  should  be  proud  to  be  physicians, 
and  we  should  hold  ourselves  in  such  an  attitude  that  we 
can  constantly  give  to  the  people  advice,  from  a  physical 
and  hygienic  standpoint,  at  least.  The  time  is  coming 


182  PRACTICAL  VISIONS 

when  a  physician  will  be  looked  to  for  psychological  and  even 
psychic  advice.  A  part  of  the  ground  may  be  covered  by 
the  minister,  as  well  as  the  physician.  The  therapeutical 
phase  should  be  dealt  with  entirely  by  the  physician,  al- 
though we  have  known  some  ministers  who  were  very  well- 
posted  along  psychological  lines. 

Start  out  in  your  work  as  a  practitioner  feeling  that 
you  should  be  symbolic  not  only  of  optimism  but  also  of 
physical  activity,  endurance,  broad  mindedness  in  your  line 
of  thinking,  and  freedom  from  certain  lines  of  mental  reason- 
ing that  are  so  common  among  those  who  do  not  know  the 
activities  of  the  nerve  tracts.  The  physician's  viewpoint 
should  be  so  much  broader  than  that  of  the  layman  that  he 
should  be  able  almost  to  read  and  understand  human  na- 
ture, not  only  from  a  physiological  and  a  pathological  stand- 
point, but  also  from  a  mental,  and  feel  master  of  the  situa- 
tion. His  mental  reasonings  should  correspond  with  a 
line  of  thought  that  is  much  better  connected,  through  his 
superior  knowledge  of  the  nervous  mechanism. 

Let  us  get  away  from  the  old  idea  of  recalling  things. 
Let  us  make  each  day  a  wonderful  day,  in  that  we  have  the 
possibilities  in  us  of  creating  new  nerve  tract  impressions, 
and  reaching  brain  cells  from  a  different  viewpoint,  and 
impressing  them  like  a  stamp  that  is  applied  to  a  new  piece 
of  wax. 

There  is  no  limitation  to  the  human  brain,  to  its  con- 
ceptions, its  revelations,  and  its  capacity  for  rearranging 
ideas  in  order  to  make  impressions  that  will  give  us  a  new 
viewpoint.  A  physician  should  so  delight  in  developing 
these  centers  and  nerve  tracts,  through  better  cerebral  co- 
ordination, that  he  will  in  time  develop  his  brain  from  a 
many-sided  standpoint  until  his  views  will  be  of  an  entirely 
different  nature  than  those  of  people  not  posted  on  human 
anatomical  and  physiological  workings. 


"FORGET  IT"  183 

There  is  no  greater  field  in  the  world  to  work  in  than 
the  therapeutic,  and  if  the  young  physician  gets  the  proper 
viewpoint  early  in  life,  and  realizes  the  great  possibilities 
along  the  various  lines,  he  will  simply  be  carried  along  by 
the  visions  that  he  will  create  from  day  to  day,  through 
having  a  practical  vision  to  start  with. 

The  last  word  has  not  been  said  regarding  diagnosing, 
and  possibly  will  not  be  for  decades  to  come.  There  is  a 
greater  chance  at  the  present  time  for  a  young  physician  to 
make  himself  world  famous  and  make  startling  discoveries, 
than  ever  before  in  the  history  of  medicine,  in  the  broader 
sense.  The  powerful  microscopes  accessible  today;  the  var- 
ious paraphernalia  used  in  making  diagnosis,  in  the  way  of 
heart  tracings  especially;  the  peculiar  development  of  sensi- 
tive touch  in  the  well-trained  osteopath,  which  was  unknown 
to  the  physician  of  a  few  years  ago;  places  the  young  phy- 
sician at  the  present  time  on  a  plane  much  superior  to  any 
that  has  ever  existed,  and  if  he  will  but  get  an  optimistic, 
practical  viewpoint,  he  will  not  look  back  and  wish  for  days 
gone  by,  but  will  plunge  into  the  future  in  his  mental  reason, 
ings  and  benefit  humanity  more  than  he  ever  dreamed  of. 


CHAPTER  XXI 


CLINICS 


CHAPTER  XXI. 

CLINICS 

For  years  we  have  felt  that  the  wisest  thing  a  young 
physician  can  possibly  do  is  to  establish  a  clinic  in  connec- 
tion with  his  work. 

Were  I  to  go  to  a  new  field  to  practice,  either  in  a  small 
town  of  two  thousand  or  over,  or  in  a  large  city,  the  first 
thing  I  would  do  would  be  to  establish  a  free  clinic,  or  assist 
in  one  already  established. 

Let  us  discuss  the  psychological  side  of  it,  as  well  as  the 
relief  side,  and  see  if  we  cannot  prove  that  work  in  a 
clinic  is  of  more  value  to  you  than  you  would  ever  dream  of, 
unless  you  had  undertaken  the  task  before.  We  would  not 
call  it  a  task.  It  is  not  only  a  pleasure,  but  most  refresh- 
ing, and  we  have  learned  more  about  infantile  paralysis, 
scoliotic  conditions,  and  various  forms  of  nervous  disorders, 
from  St.  Vitus  dance  to  convulsions,  than  we  have  in  any 
other  way;  in  fact,  I  never  did  really  understand  the  possi- 
bilities in  treating  infantile  paralysis  until  we  established 
a  free  clinic  where  we  had  from  eight  to  ten  infantile  paralysis 
cases  at  a  time,  along  with  a  much  greater  number  of  sco- 
liotic cases. 

Personally,  I  find  it  a  tremendous  tonic  to  conduct  a 
clinic.  For  years  we  held  it  three  times  a  week.  We  now 
hold  it  twice  a  week,  Tuesday  and  Saturday  mornings.  We 
commence  at  eight  o'clock.  While  it  is  necessary  to  rise 
an  hour  earlier,  in  order  to  be  at  the  office  a  little  before 
eight  o'clock  and  welcome  the  children  as  they  come,  yet 
think  of  the  mothers  who  have  to  rise,  dress,  wash,  feed, 
and  bring  their  children  to  the  clinic,  and  likewise  be  here  at 
eight  o'clock. 

—187— 


188  PRACTICAL  VISIONS 

We  have  possibly  as  large  a  clinic  during  the  length  of 
time,  as  you  will  find  anywhere.  Forty-eight  in  one  hour 
and  fifteen  minutes  is  not  uncommon,  and  unless  we  have 
forty  or  more,  we  are  not  satisfied  at  all.  Imagine  the  tonic 
effect  on  a  doctor  when  the  mothers  bring  their  children  to 
have  them  treated,  because  they  have  seen  other  children 
cured  of  a  similar  trouble.  Imagine  the  thrill  that  goes 
through  a  doctor  when  he  realizes  that  he  is  taking  off  braces, 
crutches  and  casts,  from  those  who  have  been  shackled  some- 
times for  life  at  the  suggestion  and  hands  of  the  orthopedic 
surgeon. 

To  me,  there  is  no  greater  pleasure  in  life  than  conducting 
a  free  clinic,  and  I  am  frank  to  say  that  had  I  sufficient 
money,  or  if  some  one  would  endow  me  sufficiently  to  pay  my 
expenses  the  rest  of  my  days,  I  would  treat  one  hundred 
children  free,  twice  a  week,  as  long  as  I  was  physically  able 
to  do  it.  This  would  take  about  two  hours  and  a  half  each 
day,  and  thanks  to  specific  osteopathy,  the  results  would 
compare  with  those  of  any  orthopedic  institution  in  the 
land,  and  without  a  single  instrument  or  cutting  in  any 
manner,  restoration  would  be  made,  through  the  nerve 
centers  that  control  the  circulation  that  supplies  the  cord 
sections,  as  well  as  giving  stimulus  to  the  motor  impulses 
as  they  leave  the  spinal  cord. 

There  is  no  comparison  between  what  an  orthopedic 
surgeon  can  do  and  what  osteopathy  can  do.  True  it  is  that 
an  orthopedic  surgeon  has  work  to  do  that  manipulation 
alone  cannot  do;  that  is,  there  are  a  certain  number  of  cases, 
such  as  talipes  in  its  various  forms;  but  when  it  comes  to 
muscle  transplanting,  or  tendon  shifting,  in  order  to  bring 
about  strength  and  motion  in  the  withered  limb,  I  am 
sure  that  any  good  osteopath  will  take  case  for  case  with 
any  orthopedic  surgeon  and  without  cutting  in  the  least, 


CLINICS  189 

make  resotration  in  a  greater  number  of  cases  than  the 
orthopedic  surgeon  will  do  by  his  transplanting  method. 

Then  again,  we  have  cases  of  scoliosis  in  every  form  con- 
ceivable, even  to  kyphosis  and  Pott's  disease,  which  we 
hesitate  to  take,  and  refer  them  to  the  orthopedic  surgeon, 
and  we  are  not  so  sure  that  the  orthopedic  man  will  do 
much  better  than  nature  herself  has  done. 

In  the  earlier  stages,  the  orthopedic  man  will  accom- 
plish much,  but  there  comes  a  time,  even  in  a  child's  life, 
when  it  may  be  wise  not  to  interfere  unduly  with  certain 
conditions.  However,  I  would  trust  a  case  absolutely  in 
the  hands  of  any  of  our  good  osteopathic  orthopedic  sur- 
geons, and  in  the  above  references,  for  comparison's  sake, 
we  have  invariably  referred  to  orthopedic  surgeons  of  the 
older  school,  who  are  not  trained  along  osteopathic  lines, 
who  have  never  had  the  osteopathic  vision,  and  who  know 
little  or  nothing  about  even  a  sacro-iliac  lesion.  We  are 
proud  of  our  osteopathic  orthopedic  surgeons.  They  are 
trained  to  know  the  osseous  framework  from  a  different 
standpoint  than  that  of  the  older  school.  They  are  quite 
familiar  with  the  fact  that  adjustment  will  correct  lesions, 
and  that  osseous  lesions  cause  a  great  deal  of  the  trouble  in 
the  human  framework  in  most  of  the  various  diseases. 

So,  it  is  always  a  pleasure  to  send  cases  to  an  osteo~ 
pathic  orthopedic  surgeon,  after  having  tried  osteopathy 
first;  that  is,  the  manipulative  part,  or  adjustive  work,  such 
as  Dr.  Still  longed  to  talk  about  and  loved  to  demonstrate. 

I  love  to  think  back  on  pleasant  things;  I  love  to  for- 
get unpleasant  things.  There  are  a  few  things  that  we  can 
recall  that  stimulate  us,  and  one  of  these  precious  things  is 
the  memory  of  the  Old  Doctor;  the  time  when  he  dwelt 
among  us  physically,  and  when  people  flocked  from  all  over 
the  country  to  be  restored  to  health. 


190  PRACTICAL  VISIONS 

Never  will  I  forget  that  memorable  day  when  the  Old 
Doctor,  sitting  in  the  back  yard,  was  approached  by  a  mother 
from  Colorado  with  her  little  child  in  her  arms,  beseeching 
the  Old  Doctor  to  make  physical  restoration.  Without 
getting  out  of  his  chair,  the  Old  Doctor  took  the  child  on 
his  lap,  and  in  less  than  a  minute's  time  stood  the  child  on 
the  ground,  and  the  child  walked. 

Who  else  in  the  world  at  that  time  could  correct  a  femoral 
lesion,  or  luxation,  complete,  in  that  the  head  of  the  femur 
was  entirely  out  of  the  acetabulum;  and  who  but  a  Still,  at 
that  time,  could  so  thoroughly  understand  the  mechanism 
of  the  hip  joint  that,  by  a  single  twist,  without  any  assistance, 
he  could  replace  the  head  of  the  femur  in  the  socket  and  there- 
by make  the  child  normal  again  from  a  mechanical  stand- 
point. 

The  Old  Doctor  did  not  always  use  a  treatment  table. 
He  was  known  to  back  a  patient  up  against  a  fence;  put  him 
on  the  sidewalk,  or  the  station  platform  and  correct  his 
lesions,  and  in  some  instance,  take  away  the  crutches. 

Some  will  remember  that  famous  case  where  the  Iowa 
man  was  returning  home,  not  being  satisfied  with  manipu- 
lation by  some  of  the  students.  The  Old  Doctor,  hearing  that 
the  man  was  headed  for  home,  hurried  to  the  station,  and 
grabbing  the  man  before  he  boarded  the  train,  asked  him 
why  he  was  going  home.  He  commanded  the  man  to  lie 
on  the  platform,  set  his  hip,  took  his  crutches,  and  re- 
quested him  to  stay  two  or  three  days,  and  never  were  the 
crutches  used  again. 

Who  at  the  present  time  practicing  osteopathy  could 
perform  a  similar  feat  to  the  one  above  recorded?  Are  we 
so  well  posted  in  human  anatomy  and  bodily  mechanism 
that  we  would  attempt  to  make  corrections  in  an  instant, 
without  proper  arrangement  or  accommodations,  and  ex- 


CLINICS  191 

pect  complete  restoration?  It  is  almost  inconceivable  that 
any  one  practicing  at  the  present  time  would  attempt  any 
such  procedure,  or  even  have  sufficient  confidence  in  his 
anatomical  knowledge  and  mechanical  skill  to  perform  the 
feats  that  the  Old  Doctor  did. 

After  the  clinics  each  morning,  you  feel  as  if  you  are 
limbered  up  and  ready  for  a  day's  work.  Forty-five  patients 
will  take  no  particular  strength  out  of  you,  if  you  are  thor- 
oughly imbued  with  the  osteopathic  spirit.  If  you  are  ab- 
solutely anxious  for  children  to  be  restored,  for  a  better 
generation  from  a  physical  standpoint,  you  will  take  hold  of 
these  children  with  a  zeal  that  will  equal  that  of  panning 
gold  or  washing  diggings  in  a  placer  mine. 

My  understanding  of  a  true  osteopathic  physician  is 
one  who  is  so  imbued  with  the  spirit  of  osteopathy  that  he 
will  live  it,  talk  it,  dream  it,  and  when  he  sees  a  case  where 
there  is  mechanical  malalignment,  will  not  be  able  to 
hold  himself  until  he  can  get  hold  of  that  case  and  make 
physical  restoration. 

If  you  are  not  connected  with  a  clinic,  start  one  imme- 
diately! 


CHAPTER  XXII 


FEES 


(13; 


CHAPTER  XXII. 

FEES 

There  is  one  thing  about  practicing  straight  osteopathy, 
as  they  call  it — unless  you  are  a  clever  diagnostician  and  a 
still  more  clever  adjuster,  or  manipulator,  you  will  never 
make  any  great  fortune  in  conducting  a  practice  wherein 
straight  manipulation  is  done.  However,  we  have  some 
of  the  old  timers  who  can  give  evidence  that  there  is  suffi- 
cient remuneration  in  plain  adjusting  to  warrant  the  contin- 
uation of  their  practice  and  satisfy  all  of  the  necessary  wants 
of  life. 

I  have  often  wondered  why  there  are  not  more  os- 
teopaths who  have  become  so  efficient  and  so  enamored  with 
the  science  of  osteopathy  that  they  would  be  thoroughly 
satisfied  with  their  practice,  without  spending  time  and 
money  to  venture  into  some  new  line  of  work,  which,  al- 
though possibly  osteopathic,  yet  is  sufficiently  different  to 
throw  one  out  of  the  genuine  field  of  osteopathy.  Person- 
ally, I  am  most  decided  and  most  determined,  regarding 
manipulative  treatment;  also,  I  am  thoroughly  convinced 
that  I  can  make  as  great  a  headway  practicing  straight  os- 
teopathy as  any  ordinary  specialist  or  osteopath  who  dab- 
bles in  adjuncts.  Were  I  not  satisfied  with  osteopathy  and 
the  methods  employed,  as  demonstrated  by  Dr.  A.  T.  Still, 
I  feel  that  I  would  give  up  the  title  and  branch  off  into  other 
fields,  and  not  refer  to  myself  as  an  osteopath  in  particular. 
I  have  always  contended  that  the  people  should  be  trained 
to,  and  in  time  would,  realize  that  specific  adjustment  is  the 
greatest  single  therapeutic  factor  in  the  world. 

Had  we  the  opportunity  to  make  comparative  tests 
regarding  the  treatment  of  typhoid  fever,  or  malaria,  for 

—195— 


196  PRACTICAL  VISIONS 

instance,  in  some  hospital  where  fifty  per  cent  of  the  cases 
would  be  handled  from  a  medical  standpoint,  and  fifty  per 
cent  from  an  osteopathic,  there  is  no  doubt  in  the  world 
but  that  a  true  osteopath  would  be  the  winner  in  every  in- 
stance. 

The  same  would  apply  to  pneumonia,  or  even  diph- 
theria, and  osteopathy  received  its  great  impellent  in  the 
first  place  at  Red  Wing,  Minnesota,  when  Dr.  Still's  son 
demonstrated  what  could  be  done  in  a  diphtheria  epidem- 
ic from  a  purely  osteopathic  standpoint.  Just  the 
other  day,  Dr.  Hildreth  and  I  were  talking  at  Minneapolis, 
regarding  that  particular  incident,  and  he  was  most  familiar 
with  that  demonstration  given  in  the  early  days  of  oste- 
opathy. 

We  have  referred  in  another  chapter  to  the  fact  that 
when  a  physician  is  thrown  upon  his  own  resources  and  re- 
sponsibilities, he  develops  confidence  and  will  invent 
methods  and  means  of  bodily  restoration  that  otherwise  he 
would  not  have,  if  he  had  the  opportunity  of  covering  up 
symptoms  as  the  older  schools  do,  or  have  done,  with  a  little 
morphia,  or  some  coal  tar  product. 

Any  young  man  who  will  start  out  and  go  through  an 
osteopathic  college  with  the  determination  to  be  a  proud 
follower  of  Dr.  A.  T.  Still,  and  execute  the  principles  of  os- 
teopathy after  graduation,  conscientiously  sticking  to  the 
practice  end  of  osteopathy,  will  undoubtedly  be  a  winner, 
and  will  command  respect  in  any  community.  After  all, 
it  is  a  matter  of  confidence,  backed  up  by  good  judgment 
and  a  thorough  knowledge  of  the  human  body,  that  makes  a 
physician  capable  where,  in  other  instances  the  half-hearted 
man  will  never  succeed  to  any  great  extent. 

It  does  seem  as  if  we  maght  make  ourselves  proficient 
in  one  line  of  work  in  this  world.  There  are  men  known  to 


FEES  197 

be  directors  of  five  and  six  organizations,  while  other  men 
are  contented  and  feel  overworked  running  a  little  corner 
grocery  store.  It  is  a  matter  of  vision,  practical  vision,  and 
development  of  the  mind.  The  human  brain,  if  at  all  nor- 
mal, is  capable  in  any  instance  of  development  to  the  high- 
est degree.  As  we  have  stated  before,  it  is  impossible  for 
any  human  brain  to  be  developed,  in  any  lifetime,  more  than 
a  fractional  part  of  its  functional  capacity. 

The  reason  why  some  osteopaths  fail  is  simply  this: 
They  do  not  put  their  whole  hearts  and  souls  into  their  work. 
They  are  not  sufficiently  enthused  to  take  that  particular 
interest  which  is  necessary  in  order  to  make  a  physician 
successful.  There  are  too  many  "lukewarm"  physicians. 
They  prefer  almost  anything  to  sitting  down  and  reading  a 
book  on  physiology,  anatomy,  or  psycho-analysis.  The 
truth  of  the  matter  is  this,  if  a  physician  really  wants  to  be 
successful,  he  has  to  enthuse  over  his  work  so  that  it  is  a 
constant  pleasure  to  do  his  work  from  day  to  day,  and  so 
that  he  will  go  to  bed  each  night  feeling  that  the  next  morn- 
ing will  be  a  still  greater  day,  in  that  he  will  have  met  new 
cases,  or  solved  new  problems  which  will  come  up  from  time 
to  time  regarding  various  diseases  and  symptoms. 

Even  though  a  doctor  practices  for  forty  years,  he  will 
still  have  something  to  learn.  No  two  cases  of  fever  run 
the  same  chart,  any  more  than  two  thumb  prints  will  regis- 
ter the  same  markings  or  lineations. 

Some  physicians  are  charged  with  taking  extortionate 
fees.  This  may  be  true  in  some  instances,  but  the  best  of  all 
tests  is  a  simple  one — Are  the  patients  satisfied?  If  a  doc- 
tor holds  his  practice  year  in  and  year  out  and  his  practice 
enlarges  each  year,  likewise  his  fees,  where  can  the  objec- 
tion come  in?  And  should  a  physician  be  sufficiently  generous 
hearted  to  conduct  a  free  clinic  besides  his  general  practice, 
he  should  be  given  still  more  credit. 


198  PRACTICAL  VISIONS 

There  was  a  time  in  early  osteopathy  (and  thank  good- 
ness  it  does  not  exist  to  any  great  extent  at  the  present 
time)  when  so  many  treatments  were  given  in  a  certain 
period  of  time,  and  a  certain  number  of  treatments  for  a 
certain  price.  .  The  better  physicians  at  the  present  time 
charge  either  by  the  case,  or  by  the  treatment.  Personally, 
we  have  found  the  most  satisfactory  method  is  keeping  no 
books,  and  here  arises  a  point  that  is  possibly  greatest  of  all, 
in  that  a  physician  treating  a  case  time  by  time,  and  the  pa- 
tient paying  in  the  same  way,  he  is  at  liberty  to  leave  at 
any  time,  and  it  is  the  best  test  of  the  confidence  a  doctor 
has  in  his  patient,  and  vice  versa,  that  we  know  of. 

If  an  osteopath  is  sufficiently  successful  that  he  can 
hold  a  practice  by  stating  to  his  patient,  after  examination 
and  diagnosis  have  been  made,  that  he  reasonably  expects 
a  restoration  after  a  certain  period  of  time,  and  if  the  patient 
feels  that  the  doctor  is  sincere  and  trustworthy,  there  will 
be  no  hesitation  upon  the  part  of  the  patient  in  taking  that 
certain  number  of  treatments. 

To  my  mind,  osteopathic  adjustment  is  the  highest 
skilled  work,  from  a  manipulative  standpoint,  in  the  world, 
and  possibly  no  surgeon  or  general  practitioner  of  the 
older  school  could  accomplish,  in  any  instance,  the  same 
kind  of  work,  were  he  paid  any  sum  of  money.  The  skill 
and  dexterity  of  the  osteopath's  fingers  is  the  highest  manip- 
ulative accomplishment  that  the  hands  of  man  have  ever 
known.  The  development  of  that  peculiar  sense  of  touch 
can  only  be  brought  about  by  continuous  palpation,  follow- 
ing, of  course,  a  thorough  understanding  of  the  human  body. 

After  a  few  years  of  practice,  it  is  quite  possible  for  an 
osteopath  almost  to  read  the  past  history  of  a  patient  by  the 
registrations  that  are  found  in  the  spine,  dating  back  to  a 
time  when  certain  accidents  have  happened.  Well  do  I 


FEES  199 

remember,  in  my  student  days,  when  one  of  the  older  teach- 
ers was  demonstrating  on  a  clinic  case  before  a  big  student 
body,  certain  findings  that  were  registered  in  the  spinal 
column.  While  it  seemed  almost  miraculous  to  me  at  the 
time,  and  while  I  thought  that  I  should  never  be  able  to 
accomplish  a  similar  diagnostic  feat,  yet  I  can  perfectly  well 
at  the  present  time.  It  is  like  the  beginner,  who  is  most 
desirous  of  becoming  an  artist.  He  mixes  his  paints  most 
crudely.  He  has  in  his  mind  the  combination  of  colors  to 
produce  certain  effects,  but  only  the  master  artist  can  mix 
the  colors  with  his  brains,  and  put  on  those  delicate  touches 
that  are  impossible  for  the  amateur  to  accomplish. 

The  human  framework,  to  an  osteopath,  is  one  field  of 
pulsating  tissue.  He  must  keep  in  his  mind  all  of  the  var- 
ious organs,  as  well  as  the  structures.  He  must  keep  in 
mind  the  physiological  effects  that  are  produced  by  stimu- 
lation, or  inhibition,  as  referred  to  by  some  authors.  He 
must  also  keep  in  mind  the  fact  that  there  is  such  a  thing 
as  an  idiosyncrasy,  even  in  the  application  of  manipulative 
treatment,  as  well  as  in  the  field  of  medicine. 

We  would  advise  the  young  practitioner  to  charge  ac- 
cording to  the  field  he  is  in,  and  have  in  mind  constantly  the 
raising  of  fees  commensurate  with  his  skill.  After  practicing 
for  some  time,  and  having  the  confidence  that  you  can  ac- 
complish more  in  five  minutes  than  you  could  in  three  times 
five  minutes  when  you  first  started  practice,  you  are  per- 
fectly justified  in  charging  twice  or  three  times  as  much. 

The  question  of  fees  need  not  enter  into  the  proposition 
of  general  practice  to  any  extent.  It  will  regulate  itself. 
As  you  get  results,  and  patients  become  satisfied  to  the  ex- 
tent that  they  send  you  their  friends  and  relatives,  you  will 
change  your  fees  according  to  the  results  you  are  getting. 

There  may  be  those  who  charge  too  much,  but  there 


200  PRACTICAL  VISIONS 

are  many  osteopaths  who  are  not  doing  themselves  justice, 
giving  long  treatments  and  charging  little  more  than  a 
general  masseur  or  a  chiropractor. 

There  should  be  one  great  aim  in  a  physician's  mind, 
and  that  is  to  serve  humanity  and  make  each  and  every 
case  a  star  case.  If  he  keeps  that  well  in  mind,  his  prac- 
tice is  assured,  and  he  will  never  suffer  for  lack  of  funds. 

No  student  should  ever  go  into  osteopathy  for  the 
money  that  he  may  possibly  make.  If  he  does,  he  is  b'able 
to  make  a  failure,  but  the  student  who  takes  a  course  in  os- 
teopathy with  the  one  thought  in  mind,  of  relieving  suffer- 
ing humanity  and  pursuing  a  course  of  study  that  will  give 
him  the  greatest  possible  knowledge  along  that  line,  will 
be  the  student  who  will  make  a  success  when  he  has  grad- 
uated and  gone  out  into  the  field. 

If  you  have  nice  offices  in  a  down-town  district,  you 
must  charge  accordingly  or  you  will  find  yourself  running 
behind  your  expenses.  If  you  have  a  small  office  in  a  small 
town,  you  must  not  expect  to  get  the  fees  that  the  city  man 
does.  If  you  are  a  small  town  man,  why  try  to  measure 
up  with  the  man  who  is  used  to  a  large  city  and  capable  of 
handling  three  or  four  times  the  number  of  patients  that 
you  can? 

All  of  these  things  must  be  figured  out.  The  other 
day  I  heard  a  statement  made  by  a  man,  regarding  a  class- 
mate of  his,  who  has  a  much  larger  practice  than  he  has. 
"Why  that  fellow  was  a  classmate  of  mine,  tarred  with  the 
same  stick,  and  pursued  the  same  course,  and  yet  he  thinks 
that  he  knows  more  than  I  do."  Now,  this  is  the  wrong 
attitude.  In  any  business  or  profession,  one  man  will  out- 
strip another  from  the  very  fact  that  he  knows  better  how  to 
apply  himself  to  conditions  and  people,  and  is  possibly  a 
greater  student.  And,  as  we  have  explained  in  a  previous 


FEES  201 

chapter,  the  physician  who  succeeds  best  after  graduation 
is  the  one  whose  heart  is  deepest  in  his  work,  and  who  fol- 
lows up  his  studies  by  the  latest  ideas  and  methods  of  oth- 
ers, as  well  as  the  personal  research  that  he  does  in  his  own 
office  and  laboratory. 

Go  out  into  the  field  determined  to  make  each  succeed- 
ing year  better  than  the  previous  year,  and  you  will  have 
no  difficulty,  if  you  put  your  whole  heart  and  soul  into  your 
work,  in  making  as  great  a  success  as  you  dreamed  of  when 
you  first  entered  college. 


CHAPTER  XXIII 


LETTER  WRITING 


CHAPTER  XXIII. 

LETTER  WRITING 

This  may  seem  an  unusual  subject  in  such  a  book  as 
this,  but  after  a  little  consideration  of  the  subject,  I  believe 
you  will  agree  with  me  that  it  is  not  such  a  trifling  matter 
after  all  to  consider  letter-writing  a  significant  point  in  a 
physician's  practice. 

Those  who  have  had  the  official  reins  in  their  hands,  so 
to  speak,  know  something  about  the  receiving  of  letters 
written  in  longhand  that  are  almost  beyond  deciphering. 
Just  the  other  day  I  saw  a  seven  page  letter  written  by  one 
of  the  oldest  practitioners  in  the  osteopathic  profession. 
He  sent  the  original  to  the  person  for  whom  it  was  intended 
and  a  carbon  copy  to  the  President  of  the  American  Osteo- 
pathic Association.  It  was  a  pleasure  to  have  the  oppor- 
tunity of  seeing  this  letter,  as  it  contained  some  very  good 
ideas,  but  there  were  parts  of  the  letter  almost  beyond  the 
patience  of  a  human  being  to  decipher.  It  seemed  almost 
pitiful  to  think  that  a  man  who  had  been  connected  so 
highly,  in  an  official  capacity,  for  so  many  years,  should  so 
impose  upon  his  fellow  officials  as  to  expect  them  to  decipher 
a  seven  page  letter,  closely  written  in  longhand,  with  many 
of  the  words  abbreviated 

There  is  no  excuse  for  any  one  at  the  present  day,  in  an 
official  capacity,  or  even  a  physician  in  his  own  office,  not 
to  have  at  least  one  typewriter.  The  only  alternative  would 
be  to  have  some  one  come  in  and  take  dictation  and  write 
the  letters,  especially  when  they  are  intended  for  those 
who  are  busy  in  the  world's  work. 

Many  and  many  a  letter  we  have  had  to  have  decipher- 
ed by  some  one  else  before  reading  it,  in  order  to  save  time. 

—205— 


206  PRACTICAL  VISIONS 

It  is  no  trouble  to  pick  up  a  typewritten  letter  and  get  the 
gist  of  it  within  a  few  moment's  time,  after  which  you  can 
read  it  more  carefully;  but  when  we  receive  a  letter  of  from 
two  to  seven  pages,  as  we  often  do,  even  nine  pages,  written 
in  longhand,  we  are  of  the  opinion  that  there  is  lack  of  train- 
ing or  lack  of  appreciation  of  the  time  of  those  who  are  so 
busy. 

A  physician  can  have  no  better  training  than  that 
resulting  from  the  practice  of  dictating  letters  and  articles 
day  by  day.  The  importance  of  well-typed  letters,  on  good 
stationery,  is,  from  a  psychological  standpoint,  almost  be- 
yond conception.  About  one  typewritten  letter  in  ten  is 
anywhere  near  perfection  from  a  typist's  standpoint.  One 
can  almost  judge  the  kind  of  practice  a  physician  has  by  the 
letters  he  sends  out.  If  you  have  never  thought  of  this, 
try  it  out.  Write  a  dozen  letters,  call  for  answers,  note  the 
kind  of  replies  you  receive,  including  stationery  used,  and 
see  if  you  do  not  agree  with  me  that  the  stationery  and 
writing  of  the  letters,  whether  longhand  or  typewritten,  will 
indicate  to  a  great  extent  the  kind  of  practice  that  a  phy- 
sician has. 

True  it  is  that  some  of  our  best  practitioners  often 
scratch  off  a  few  lines  to  their  friends,  who  are  fellow  prac- 
titioners; but  those  who  have  had  experience  in  receiving 
and  sending  hundreds  of  letters  a  year,  almost  invariably 
use  the  typewriter  to  convey  their  messages. 

Elbert  Hubbard  set  a  wonderful  example,  in  that  he 
considered  it  good  training,  and  a  part  of  one's  education, 
to  have  the  best  of  stationery  and  the  best  possible  type- 
written expression  in  every  letter.  He  was  one  of  the  origi- 
nal watermark  people,  and  those  who  received  letters  from 
him  on  his  own  private  Italian  watermarked  stationery, 
in  which  his  likeness  is  watermarked  so  perfectly,  appreciate 


LETTER  WRITING  207 

the  tone  and  class  of  the  man  whose  vocabulary  has  never 
been  excelled  on  the  American  continent 

There  is  something  about  good  stationery  that  lifts 
a  man  up,  and  if  it  is  the  best  bond,  or  the  best  linen  paper, 
with  appropriate  envelopes,  there  is  something  about  the 
neatly  typewritten  sheet  that  makes  one  feel  as  if  he  were 
entertaining  high  ideals. 

When  we  receive  a  typewritten  letter,  where  a  number 
of  words  are  misspelled,  or  the  letters  blurred,  it  simply 
indicates  that  there  is  a  letting  down  in  the  tone  of  the 
office.  There  is  no  excuse,  at  the  present  day,  for  poorly 
typed  letters,  or  lack  of  distinctness  in  type.  The  machines 
put  out  today,  both  typewriters  and  mimeographs,  are  al- 
most perfect  in  their  mechanism,  and  with  a  careful  opera- 
tor everything  should  be  absolutely  neat  and  perfect. 


CHAPTER  XXIV 


NEW  PATIENTS 


(14) 


CHAPTER  XXIV. 

NEW  PATIENTS 

In  this  chapter  we  will  deal  in  particular  with  the 
handling  of  new  patients. 

I  do  not  think  any  doctor  should  take  all  the  cases 
that  come  to  him  for  treatment.  This  immediately  raises 
the  question  as  to  what  kind  of  cases  should  be  refused, 
and  since  osteopathy  is  such  a  wonderful  therapy  why 
should  not  a  patient  be  given  the  benefit  of  the  doubt,  and 
the  doctor  at  least  attempt  to  do  something  for  him? 

Suppose  you  go  into  a  new  place  and  establish  your 
office  and  the  first  patient  who  comes  is  one  that  you  will 
never  be  able  to  give  more  than  slight  benefit.  If  you  take 
this  case  on  for  treatment,  and  after  a  few  weeks'  time 
you  realize  that  he  is  not  satisfied  and  that  you  have  not 
made  good,  you  have  lost  in  that  section  of  the  town  where 
he  lives  not  only  that  patient,  but  possibly  all  of  his  friends. 

After  taking  four  of  these  hopeless  or  unsatisfactory  cases 
from  four  different  parts  of  a  town,  you  will  possibly  wonder 
in  a  year's  time  why  you  are  getting  ready  to  leave  that 
town. 

The  first  patient  I  examined  in  Toronto  I  refused.  It 
happened  to  be  a  case  that  would  never  be  exactly  satisfac- 
tory, from  my  standpoint  Because  of  my  refusing  this  case 
another  member  of  the  family  came  to  me,  and  through  it 
I  secured  a  sufficient  number  to  pay  expenses  in  a  very 
short  time.  I  have  made  it  a  rule  regardless  of  whether  I 
am  busy  or  not,  absolutely  to  refuse  to  take  a  case  if  for 
any  reason  I  feel  that  I  should  not  do  so.  I  contend  that 
this  is  a  physician's  privilege,  and  in  nine  cases  out  of  ten 
you  will  find  that  the  patient  will  admire  you  for  your  frank- 

—211— 


212  PRACTICAL  VISIONS 

ness,  and  you  will  be  rewarded  for  your  honesty  in  that  the 
refused  case  will  soon  spread  the  news  among  his  friends. 
When  you  stop  to  think  of  it,  you  are  not,  as  a  rule,  the  only 
physician  in  that  town  and  if  they  want  treatment  of  any 
description,  there  are  others  who  will  possibly  be  willing 
to  take  the  case.  It  is  not  like  the  case  of  a  doctor  in  a 
rural  district  where  there  is  no  other  doctor  for  miles 
around. 

By  keeping  your  practice  within  your  control  in  that 
you  feel  that  you  can  benefit  every  case  you  are  treating, 
you  are  going  to  make  greater  headway  not  only  for  your- 
self, but  for  those  who  live  in  that  community.  Why 
should  a  doctor  burden  himself  down  with  four  or  five 
almost  hopeless  cases,  when  through  taking  them  on  he  is 
keeping  persons  who  could  be  helped,  from  coming  to  his 
office?  People  will  watch  their  neighbors,  and  they  usually 
know  when  they  are  going  to  an  osteopath.  They  are 
closely  questioned  as  to  improvement  or  lack  of  improve- 
ment and  the  friends  of  a  case  that  is  not  improving  will 
seldom  venture  to  come  to  you  unless  the  patient  you  have 
been  treating  will  recommend  you. 

In  a  frank  manner  I  have  stated  the  attitude  assumed 
toward  chronic  cases  that  cannot  be  relieved  to  any  great 
extent.  You  will  want  to  know  what  kind  of  cases  cannot 
be  helped,  and  in  brief,  I  will  say  that  in  every  known  disease 
from  rheumatism  to  anemia,  you  will  find  cases  that  have 
reached  a  certain  point  where  pathological  changes  are 
such  that  you  will  find  it  quite  impossible  to  make  restora- 
tion. There  are  also  certain  forms  of  paralysis,  even  paraly- 
sis agitans,  also  chorea  as  well  as  sclerosis  that  you  might 
better  leave  alone. 

Later  on,  after  you  are  well  established,  you  can  take 
these  cases  one  by  one  and  they  will  not  hurt  you  as  much 


NEW  PATIENTS  213 

if  you  feel  from  a  humanitarian  standpoint  that  you  should 
give  relief  to  every  person  that  applies  to  you.  But  I  prefer 
the  long  distance  vision  in  which  eventually  I  can  reach  the 
greatest  number  of  people,  and  give  the  greatest  amount  of 
relief  in  the  quickest  possible  tune,  and  to  my  mind  this 
can  be  done  only  by  selecting  your  cases  and  giving  them 
concentrated  attention  from  a  specific  standpoint. 

There  is  nothing  I  have  said  in  this  chapter  but  what  has 
worked  out  in  actual  practice,  and  while  I  refuse  an  oc- 
casional case  for  various  reasons  and  while  I  also  lose  to 
some  other  practitioner  an  occasional  case  through  giving, 
apparently,  too  specific  a  treatment,  yet  taking  it  all  in  all, 
I  have  found  it  possible  to  handle  a  tremendous  practice, 
and  to  relieve,  during  the  course  of  a  year,  as  well  as  re- 
store  to  normal,  a  far  greater  number  of  persons  than 
should  I  have  adopted  the  older  policy  of  "giving  a  patient 
his  money's  worth,"  as  so  many  refer  to  it. 

We  have  never  given  a  chronic  case  a  diagnosis  on  the 
same  day  we  make  the  examination,  and  follow  the  same 
practice  even  in  some  acute  cases.  We  are  not  referring 
here  to  emergency  cases.  After  making  all  the  various 
tests,  palpating  all  of  the  various  areas,  taking  into  consid- 
eration the  lymphatic  diagnostic  symptoms  in  the  way  of 
edematous  areas,  using  the  blood  pressure  machine  and  the 
stethoscope  and  testing  the  reflexes,  we  call  for  a  specimen 
of  urine  for  testing  purposes  and  should  an  X-ray  examina- 
tion be  found  necessary,  we  invariably  refuse  to  give  a 
diagnosis  until  we  are  satisfied  as  to  the  real  condition. 
There  may  be  pseudoankylosis  or  a  sclerosis,  or  an  extra  rib 
accumulation,  gall  stones,  forms  of  renal  calculi  or  one  of  a 
number  of  other  conditions  that  would  cause  a  thoughtful 
physician  to  hesitate  in  giving  his  diagnosis  and  prognosis 
when  he  has  been  referred  to  by  some  person  as  the  court  of 
last  resort. 


214  PRACTICAL  VISIONS 

In  one  chapter  we  have  emphasized  alertnes  and  we 
again  say  that  a  doctor  cannot  be  too  careful  in  making  an 
examination  It  is  not  always  necessary  to  make  ail  of  the 
tests  before  treatment  is  begun,  but  we  always  wait  at  least 
twenty-four  hours  before  giving  our  diagnosis  and  telling  a 
patient  whether  we  will  take  his  case  or  not.  We  find  this 
bit  of  anticipation  very  satisfactory  in  every  respect.  It  also 
gives  a  chance  for  second  thought,  and  I  am  of  the  opin- 
ion that  it  is  well  to  weigh  in  your  mind  over  night,  or  dur- 
ing the  twenty-four  hours,  the  case  in  its  various  aspects 
and  figure  out  in  your  own  mind  whether  you  are  justified 
in  taking  hold  of  that  case  and  promising  verbally  or  from 
any  other  standpoint,  relief  such  as  the  patient  thinks  he  is 
going  to  receive. 

It  is  just  as  well  to  have  the  impression  go  around 
that  you  will  not  take  every  case.  The  greatest  institution 
in  the  Northwest  has  that  reputation.  They  have  worked 
on  a  certain  basis  for  years  and  many  are  the  cases  that 
have  been  sent  home  from  that  famous  place  just  for  the 
reason  that  the  physicians  decided  that  they  were  not  ab- 
solutely positive  that  it  was  wise  to  operate. 

When  your  new  patient  returns  the  next  day  for  his 
diagnosis,  tell  him  in  a  frank  manner  that  you  are  delighted 
to  take  his  case,  and  after  due  consideration  and  compar- 
ative notes,  including  the  various  tests  made,  you  are  reason- 
ably sure  that  it  would  be  wise  for  him  to  take  the  treat- 
ment. When  he  asks  how  long  it  will  take,  don't  quote 
months  or  years,  but  realize  that  specific  osteopathy  deals 
with  weeks  as  a  rule,  and  that  if  osteopathy  can  handle 
the  case  in  three  or  four  weeks'  time,  he  will  be  satisfied  to 
continue  the  treatment. 

If  the  case  is  of  such  a  nature  that  you  do  not  feel  that 
you  care  to  take  it,  tell  him  so.  Also  state  that  some  other 
physician  would  possibly  be  perfectly  willing  to  take  the 


NEW  PATIENTS  215 

case,  and  might  be  able  to  handle  it  far  better,  in  that  he 
might  have  had  more  experience  along  that  particular  line. 
It  will  not  hurt  you  to  let  a  case  go;  it  will  do  you  good.  How 
can  any  physician  take  hold  of  a  case  and  give  that  pa- 
tient treatment  when  he  is  not  clearly  satisfied  in  his  own 
mind  that  he  will  be  able  to  restore  that  patient?  That  very 
thing  will  shake  your  own  confidence,  and  you  cannot 
afford  to  have  it  shaken.  Do  nothing  that  will  tend  to 
shake  your  confidence  in  handling  any  case,  and  you  will 
eventually  come  to  feel  that  should  an  occasional  case, 
through  some  perverted  pathological  condition,  fail  to  re- 
spond to  your  treatment,  as  other  similar  cases  have  done, 
you  will  know  that  you  have  given  the  patient  the  best 
attention  that  you  possibly  could  and  in  all  sincerity  be 
true  to  yourself  in  handling  cases,  and  your  patients  will 
realize  it  and  admire  you  for  it. 

When  you  have  established  a  reputation  of  this  kind, 
you  will  find  that  almost  invariably  your  patients  will 
smile  in  a  joyous  manner  when  you  tell  them  that  you  will 
take  them  on  for  treatment.  This  is  not  psychology  neces- 
sarily, it  is  plain  straight  Abraham  Lincoln  honesty. 

When  you  have  on  your  list  fifty,  one  hundred  or  one 
hundred  and  fifty  patients  coming  every  day  or  every  other 
day,  or  even  twice  a  week,  and  every  patient  assures  you 
by  his  attitude  that  he  has  absolute  confidence  in  you, 
then  and  there  you  are  happy  in  your  work  and  satisfied 
that  you  are  doing  all  you  possibly  can,  and  at  the  same  time 
you  are  desirous  of  doing  more  for  them.  It  is  a  good 
atmosphere  to  live  in.  Be  honest  with  your  patients  and 
give  them  the  best  you  have.  Let  no  day  pass  without 
thinking  of  the  Founder  of  Osteopathy.  He  battled  alone 
in  the  world,  against  all  odds  imaginable  and  he  lived  to 
see  the  day  when  his  great  scientific  truths  were  implanted 
in  the  minds  and  hearts  of  millions  of  the  American  people. 


CHAPTER  XXV 


TREATMENT  ROOM 


CHAPTER  XXV. 

TREATMENT  ROOM 

Some  time  ago  we  wrote  an  article  entitled,  "How  do 
you  put  in  so  much  time  in  the  treatment  room?"  We 
received  a  great  number  of  letters  regarding  this  particular 
article.  We  will  refer  to  certain  points  of  interest  con- 
tained  in  that  article  and  bring  out  some  of  the  major  points 
that  will  interest  practitioners  more,  possibly  than  some  of 
the  minor  points  that  need  not  be  discussed  in  this  chapter. 

Some  doctors  have  the  idea  that  they  must  converse 
with  the  patient  after  passing  the  time  of  day  on  entering 
the  treatment  room,  and  also  ask  the  patient  how  he 
has  been.  This  takes  time.  Possibly  the  doctor  has 
plenty  of  time  to  spare,  and  some  doctors  may  think  that  a 
nervous  woman  needs  to  be  approached  gently  as  we  have 
a  great  many  cases  of  neurasthenia.  We  have  found  in 
our  practice,  that  first  impressions  are  the  strongest, 
and  that  in  reality  a  patient  likes  to  see  his  doctor  work. 

We  are  in  the  habit  of  giving  treatment  without  a 
coat.  As  soon  as  we  enter  the  treatment  room,  the  coat  is 
hung  up  and  we  are  ready  for  business.  If  a  patient  has 
the  inclination  to  talk,  our  very  attitude  is  against  it  in 
that  we  seem  so  busy,  and  proceed  without  asking  the  pa- 
tient any  questions,  and  sometimes  give  a  patient  fully 
half  of  his  treatment  before  saying  a  word.  Now  this 
does  not  imply  that  we  are  hurrying  the  case,  or 
that  we  intend  to  give  a  short  rapid  treatment,  but  to  me  it 
means  that  whatever  can  be  done  from  an  osteopathic 
standpoint  can  and  should  be  done  in  the  quickest  possible 
time. 

—219— 


220  PRACTICAL  VISIONS 

There  is  something  peculiar  from  a  psychological  stand- 
point in  the  fact  that  as  a  rule  a  rapid  treatment  is  of  much 
more  value  to  a  patient  than  a  slow,  drawn  out  treatment. 
The  other  day  I  was  taking  a  treatment  and  the  doctor 
started  to  talk  as  soon  as  I  entered  the  room,  also  continued 
talking  as  he  took  hold  of  my  side  to  manipulate  the  muscles. 
His  hands  were  cold  and  he  seemed  to  have  no  particular 
vitality,  although  supposedly  a  strong  man.  Keeping  on 
with  the  talking,  he  pulled  away  at  the  muscles,  trying,  ap- 
parently, to  relax  them  and  it  was  fully  three  or  four  minutes 
before  he  had  gotten  down  to  business.  This  made  me 
nervous,  and  I  believe  you  can  make  a  patient  more  ner- 
vous by  dilly-dallying  and  by  too  much  verbosity  than  by 
taking  hold  of  him  with  a  firm  hand  and  doing  cor- 
rective work  in  a  scientific  manner.  I  do  not  jump  at  a 
patient,  but  I  move  rapidly,  and  my  mind  is  so  centered 
on  what  I  am  trying  to  accomplish,  that  the  patient  re- 
alizes that  I  have  entered  the  room  to  give  the  best  service 
possible  in  the  necessary  length  of  time. 

Strange  it  may  seem  when  I  state  that  if  I  had  but  one 
patient  waiting  in  a  treatment  room  and  the  other  four 
were  vacant,  I  would  give  the  same  quick  specific  treatment, 
and  linger  only  sufficiently  long  to  do  my  work.  Patients 
like  for  you  to  take  off  your  coat  and  get  down  to  business. 
We  have  done  it  for  years,  and  while  the  treatment  is  most 
specific,  yet  the  patient  feels  that  you  are  giving  him  your  en- 
tire attention  from  a  concentrated  standpoint.  For  example, 
a  lady  came  into  the  office  today  with  her  husband,  complain- 
ing of  a  bad  knee.  In  a  moment's  time  she  was  lying  down 
ready  for  attention.  As  soon  as  I  took  hold  of  the  knee  I 
found  the  cartilage  slightly  slipped.  It  took  about  ten  seconds 
to  replace  it.  I  had  her  turn  on  her  side  and  rotated  the 
lumbar  region,  then  on  her  face,  and  sprung  both  innomin- 


TREATMENT  ROOM  221 

ates  to  determine  the  amount  of  mobility.  I  considered  that 
sufficient  treatment  for  one  day.  She  jumped  up  and  started 
to  dance  Her  husband  told  her  she  had  better  not  do  that 
on  a  weak  knee  and  she  refrained.  The  correction  of  one  in- 
nominate and  the  replacing  of  the  cartilage  was  quite  suffi- 
cient. She  had  come  only  to  have  her  knee  fixed.  That  is 
specific  osteopathy.  She  seemed  in  perfect  health  other- 
wise and  only  desired  to  have  her  knee  fixed. 

The  next  case  was  a  man  who  had  fallen  on  his  arm 
several  months  previously  and  the  tendon  of  the  biceps  was 
out  of  the  groove  in  the  humerus.  Remembering  the  Old 
Doctor's  method  of  replacing  this  tendon,  I  gave  the  arm 
one  swing  and  turned  the  thumb  backward  and  outward, 
felt  the  tendon  slip  back  into  place  and  with  one  spring  on 
the  outer  end  of  the  clavicle  the  shoulder  was  again  restored 
to  normal.  The  man  did  not  ask  for  general  treatment. 
He  simply  wanted  his  shoulder  relieved.  There  are  cases  like 
this  that  are  practically  emergency  cases  and  it  is  not  always 
necessary  to  give  them  a  general  systemic  examination  when 
they  do  not  request  it. 

In  making  a  general  examination  we  spare  no  pains  in 
going  into  details.  We  have  referred  to  this  in  another  chap- 
ter, and  we  will  confine  ourselves  in  this  chapter  to  the  man- 
ner and  method  of  approaching  and  treating  patients,  also 
leaving  the  room  after  treating  a  patient. 

Seldom  does  any  case  require  more  than  ten  minutes 
for  treatment  and  many  cases  do  not  require  more  than  two 
or  three  minutes.  Had  the  osteopaths  all  over  the  world 
confined  themselves  to  specific  work,  osteopathy  would  be 
in  a  position  today  that  would  command  the  attention  of 
all  peoples.  There  may  be  a  possibility  that  lack  of  train- 
ing in  the  colleges  has  had  something  to  do  with  the  great 
length  of  time  put  in  in  the  treatment  room,  but  we  are  in- 


222  PRACTICAL  VISIONS 

clined  to  lay  the  blame  on  the  doctor.  His  lack  of 
confidence  in  himself  and  his  desire  to  give  his  patient  his 
money's  worth,  so  to  speak,  and  to  impress  the  patient 
with  the  idea  that  he  is  thorough  and  painstaking,  so  that 
he  will  be  able  better  to  hold  them,  has  had  to  do  with  the 
lengthy  treatments  that  are  quite  universally  given. 

We  take  this  attitude  and  as  it  works  out  in  a  charming 
manner  we  have  no  desire  to  change.  Our  attitude  has 
already  been  outb'ned  in  that  we  are  inclined  to  believe  that 
the  patient  wants  speedy  relief,  and  the  more  specific 
the  work  you  perform,  the  greater  the  impression  you  make 
on  the  patient.  Likewise  a  patient  is  always  perfectly  will* 
ing  and  anxious  to  be  relieved  of  his  trouble  in  the  quickest 
possible  time. 

In  the  instances  referred  to  above,  along  the  emergency 
line,  examination  and  treatment  all  together  occupied  less 
than  five  minutes'  time.  In  order  to  be  able  to  do  this 
specific  work  and  to  be  satisfied  in  your  own  mind  that  you 
are  able  to  diagnose  and  do  the  corrective  work  from  an 
absolutely  mechanical  standpoint,  you  must  train  your  mind 
along  that  particular  line.  This  can  very  readily  be  done 
and  with  no  fear  of  losing  your  patients,  you  can  give  them 
ease  from  pain  or  freedom  of  motion  in  their  various  joints, 
in  many  instances  in  a  very  short  period. 

The  other  day  we  had  a  man  to  come  in  who  had  lifted  a 
large  ash  can  and  produced  a  lumbar  lesion.  He  simply 
wanted  relief  in  the  quickest  possible  manner  as  he  had  to 
drive  a  number  of  miles  that  day  and  did  not  want  to  wait 
very  long.  We  placed  him  on  his  back,  measured  his  feet, 
examined  the  hips,  turned  him  on  the  right  side,  gave  one 
single  rotation  in  the  lumbar  region  locking  the  vertebrae 
in  a  manner  so  as  to  concentrate  force  upon  the  lesioned  area, 
and  with  this  one  single  rotation  we  realized  that  the  correc- 


TREATMENT  ROOM  223 

tion  was  made,  and  told  him  that  was  sufficient  for  this 
time ;  if  it  bothered  him  again  to  come  in.  He  drove  over 
one  hundred  miles  that  day,  and  has  had  no  further  discom- 
fort, and  we  have  treated  two  members  of  his  family  since. 

What  I  am  trying  to  impress  on  the  young  practitioner 
is  this,  that  specific  treatment  will  enable  him  to  handle 
practice  and  increase  his  practice  far  better  than  the  long 
drawn  out  muscle  kneading  treatments  in  which  one  might 
just  as  well  write  out  on  a  piece  of  paper,  "We  aim  to  please 
and  give  you  your  money's  worth."  The  attitude  of  a 
physician  should  be  this :  One  of  extreme  confidence  backed 
by  ability  and  an  earnest  desire  to  accomplish  the  greatest 
amount  in  the  least  possible  time. 

Picture  in  your  mind,  if  you  are  practising  in  a  large  city, 
the  great  throngs  who  are  suffering  and  are  disabled  in 
some  respect.  Say  to  yourself :  There  are  at  least  five  thou- 
sand persons  in  this  city  this  morning  who  need  osteopathic 
treatment.  "I  cannot  treat  them  all,  only  a  fraction  of  them, 
but  I  will  give  relief  to  as  many  as  I  possibly  can,  and  they 
will  bring  others.  In  time  I  will  reach  a  great  many  of  the 
five  thousand." 

With  this  particular  viewpoint  in  mind  you  will  be  able 
to  accomplish  a  great  deal  more  when  you  realize  that  you 
cannot  treat  more  than  seventy-five  or  eighty-five  in  one 
day.  The  remaining  four  thousand  plus  will  have  to  go 
on  suffering,  or  secure  relief  by  other  methods,  or  possibly 
be  handled  by  fellow  practitioners. 

There  is  no  excuse  for  not  having  a  tremendous  prac- 
tice in  a  large  city,  as  there  is  any  amount  of  work  to  be  done, 
and  if  you  want  the  people  back  of  you  and  in  sympathy  with 
you,  keep  your  clinics  going.  Show  the  people  you  are  just 
as  willing  to  treat  children  of  poor  parents  as  those 
of  the  rich  people.  After  all,  the  anatomy  of  the  human 


224  PRACTICAL  VISIONS 

body  is  practically  the  same  in  every  human  being.  A 
pain  is  a  pain  the  world  around.  Sciatica  is  sciatica  whether 
it  is  in  the  Chinaman  or  Anglo-Saxon.  Rheumatism  affects 
every  known  race  and  neuritis  has  been  found  in  every  clime. 

Suppose  you  have  a  patient  who  is  talkative,  always 
asking  questions,  wants  to  know  this,  that  and  the  other. 
Let  me  tell  you  how  to  handle  him.  In  some  instances  one 
will  ask  whether  talking  bothers  you.  Invariably  say 
"  Yes",  and  that  you  will  answer  any  questions  after  you  get 
through  with  the  treatment.  If  he  insists  on  talking,  give 
a  little  extra  force  on  some  lesioned  area,  and  ask 
if  that  point  is  sensitive.  If  that  does  not  stop  him, 
put  him  on  his  face  immediately  and  spring  the  innom- 
inates,  or  rock  the  sacrum. 

A  physician  should  never  discuss  politics,  religion  or 
gossip.  If  they  ask  you  your  religion,  tell  them  you  are 
an  osteopath;  or  politics,  tell  them  the  same;  and  what  paper 
you  read,  tell  them  you  take  all  the  papers,  which  we  have 
done,  by  the  way,  for  years.  If  they  ask  regarding  some 
disease,  tell  them  you  will  have  the  nurse  hand  them 
a  booklet  when  they  leave  the  room.  Always  be  on  the  alert, 
head  them  off  to  keep  them  from  talking  and,  of  course,  do 
very  little  yourself.  Go  into  the  treatment  room  as  if  you 
were  determined  to  restore  them  immediately,  also  make 
each  one  feel  as  if  his  case  was  the  only  case  you  were  handling, 
or  at  least,  you  were  as  much  interested  in  his  case  as  a 
physician  possibly  could  be. 

It  is  absolutely  necessary  to  have  sufficient  rest  and  sleep 
to  keep  in  mind  what  the  patient  has  told  you  at  some  pre- 
vious date.  And  there  are  those  who  will  try  to  corner  you 
and  see  if  your  latest  diagnosis  corresponds  with  your  first 
diagnosis.  Alertness  is  one  of  the  greatest  factors  in  a 
physician's  make-up. 


TREATMENT  ROOM  225 

Each  treatment  room  should  contain  the  latest  maga- 
zines and  a  few  books.  Let  no  magazines  remain  in  a  room 
that  are  not  current  numbers,  and  take  a  sufficient  number 
to  show  that  you  are  broad-minded. 

Each  room  should  contain  a  fan,  an  electric  heater 
for  chilly  days,  and  a  large  steamer  rug. 

It  is  a  mistake  to  have  a  patient  use  a  treatment  room 
for  a  rest  room.  Invariably  tell  lady  patients  to  go  straight 
home  and  rest  for  an  hour,  lying  on  the  back  or  in  a  comfort- 
able position.  We  do  not  let  them  go  shopping,  and  we  do 
not  encourage  their  remaining  at  the  office  for  any  length 
of  time,  and  seldom  do  we  have  any  one  lingering  unless 
it  be  one  who  has  come  to  the  office  in  a  run-down  and  de- 
pleted condition,  to  the  extent  that  he  needs  to  rest  five  or  ten 
minutes  before  starting  for  home. 

By  giving  short  specific  treatments,  you  will  not  tire 
a  patient  to  any  extent,  and  as  a  rule,  the  patient  will  be 
refreshed.  Keep  the  treatment  room  for  patients  to  come 
to  have  their  treatment,  and  go  out  as  promptly  as  possible, 
so  that  others  also  may  have  a  chance. 


(15) 


CHAPTER  XXVI 


ADVERTISING 


CHAPTER  XXVI. 

ADVERTISING 

Without  any  doubt,  it  always  pays  to  advertise.  Of 
course,  a  physician  must  advertise  in  an  ethical  manner, 
and  that  consists,  briefly,  of  using  chiefly  the  literature  pub- 
lished by  some  of  our  progressive  osteopaths  who  are  in- 
clined  in  that  direction. 

I  am  a  great  believer  in  educating  the  public,  and  I 
would  use  the  word  "advertising"  advisedly,  as  no  physi- 
cian cares  to  refer  to  his  propaganda  work  as  an  advertising 
proposition. 

To  rely  upon  the  sending  out  of  osteopathic  literature 
as  the  principal  means  of  creating  and  maintaining  a  prac- 
tice is  absolutely  the  wrong  idea;  but  sending  out  a  reason- 
able amount,  at  regular  intervals,  is  usually  a  very  wise 
idea.  If  you  send  out  too  great  an  amount  at  one  time, 
people  will  think  you  are  in  need  of  practice;  and  if  you 
send  out  no  literature  for  a  period  of  time  they  think  you 
are  going  to  leave  town.  They  will  not  think  of  it  as  being 
due  to  the  fact  that  you  are  so  busy  that  you  do  not  want 
any  more  patients  for  a  while.  They  will  simply  conclude 
that  you  are  either  not  interested,  or  that  you  cannot  afford 
to  carry  on  a  publicity  campaign. 

Personally,  we  use  more  of  the  Osteopathic  Magazine 
than  any  other  publication.  There  is  no  doubt  in  the  world 
but  that  the  booklets,  leaflets  and  brochures  published  by 
my  old  classmate,  Harry  Bunting,  also  those  by  the  great 
publisher  of  the  Mississippi  Valley,  R.  H.  Williams,  are 
exceptionally  good,  and  we  also  use  a  great  deal  of  both  kinds. 
Then  there  are  special  booklets  and  brochures  published 

—229— 


230  PRACTICAL  VISIONS 

elsewhere  that  are  also  of  great  merit;  but  the  main  point  is 
to  place  reading  matter  in  the  hands  of  those  who  are  inter- 
ested,  or  who  are  taking  osteopathic  treatment,  and  not 
to  send  out  a  promiscuous  list  to  every  one  and  expect  that 
you  are  going  to  get  great  results.  Personally,  we  have 
not  for  many  years  sent  out  any  literature  except  at  the  re- 
quest of  some  patient.  Two  or  three  hundred  copies  of  a 
special  number  mailed  out  to  those  whom  you  know  will 
use  them  to  good  advantage,  is  certainly  of  greater  value 
than  spasmodic  attempts  to  reach  all  of  those  in  the  phone 
book  one  month  and  the  Blue  Book  another  month. 

We  certainly  believe  there  are  a  lot  of  osteopaths  who 
do  not  send  out  sufficient  literature.  There  are  very  few 
who  send  out  too  much.  We  are  inclined  to  believe  that 
the  sending  out  of  more  literature  will  help  to  educate  the 
people  so  that  they  will  become  sufficiently  interested  in 
osteopathy  to  recommend  it  to  their  friends,  as  well  as  keep 
up  occasional  treatment  on  their  own  part. 

It  is  a  mistake  to  try  to  put  out  your  own  literature 
when  there  are  those  who  have  given  it  a  lifetime  of  study 
and  can  select  the  very  best  material  from  various  sources. 
Almost  every  one  has  had  the  experience  of  feeling  at  times 
that  he  would  like  to  write  a  certain  article,  or  put  out  a 
certain  piece  of  literature  that  would  hit  the  nail  on  the  head; 
but  if  you  will  look  very  carefully  over  the  various  pieces  of 
literature  that  have  been  published,  or  write  to  the  pub- 
lishers and  ask  them  for  a  list,  you  will  soon  realize  that 
very  few  of  the  basic  points  in  osteopathy  have  not  been 
treated  at  some  time  or  other. 

While  it  is  very  well  to  circulate  a  reasonable  amount 
of  literature  regularly  (that  is,  at  least  ten  months  in  the 
year)  we  are  inclined  to  believe  that  the  greatest  publicity 
that  any  physician  can  receive,  without  exception,  comes 


ADVERTISING  231 

from  so  conducting  his  practice  and  securing  results  through 
specific  adjustment,  that  his  patients  will  talk  for  him  at 
all  times.  When  you  get  fifty  or  seventy-five  persons  putting 
in  a  -good  word  for  you  at  various  social  gatherings,  after- 
noon tea-parties,  evening  dances,  and  after-church  inter- 
views, then  you  will  find  that  you  have  working  for  you, 
people  whose  services  you  could  never  pay  for,  and  to  whom 
no  one  would  listen  but  those  who  knew  them;  and  event- 
ually, when  new  patients  come  into  your  office,  they  will 
say  that  they  were  referred  by  "so  and  so,"  who,  in  turn, 
had  taken  previous  treatment  through  hearing  of  some  one 
else  who  had  been  cured;  also  through  reading  osteopathic 
literature. 

It  is  in  this  way  that  we  get  the  majority  of  cases  from 
year  to  year.  Literature  well-placed  in  the  hands  of  those 
who  have  been  benefited  by  osteopathy,  will  do  more  good 
than  ten  times  that  amount  of  literature  promiscuously 
placed. 

Be  sure  to  keep  a  very  carefully  selected  list  of  those 
who  you  know  will  receive  the  literature  you  send  to  them 
and  use  it  to  the  very  best  of  advantage. 

The  publicity  campaign  question  is  quite  a  serious  one, 
and  all  kinds  of  phases  present  themselves;  in  fact,  the  mat- 
ter has  never  been  satisfactorily  settled  as  yet,  and  possibly 
never  will  be.  It  is  just  a  question  of  going  about  it  in  the 
most  ethical  manner  possible,  and  getting  results  in  a  way 
that  will  not  be  offensive  to  the  public  as  a  whole. 

Each  man  has  his  own  idea  of  advertising.  Some  think 
that  they  need  not  advertise  at  all  if  they  do  the  good  work. 
That  is  rather  a  selfish  motive,  as  no  matter  how  large  a 
practice  may  be,  even  if  one  be  turning  patients  away,  for 
the  sake  of  osteopathy  in  general  and  the  assisting  of  those 
who  are  less  busy,  it  is  necessary  that  we  carry  on  a  systemat- 


232  PRACTICAL  VISIONS 

ic  campaign  to  educate  the  people  as  to  the  true  principles 
of  osteopathy. 

The  people  are  not  so  well-posted  but  that  you  will  find 
in  your  own  practice,  for  instance,  that  certain  patients  will 
ask  you  regarding  a  certain  disease,  and  say,  "Well,  I  didn't 
know  that  osteopathy  could  handle  that  disease,  or  I  would 
not  have  advised  my  son  to  go  to  a  specialist  to  have  his 
trouble  treated."  We  hear  this  every  day,  and  it  will  be 
many  years  yet  before  the  people  will  become  so  familiar 
with  osteopathic  truths  that  they  will  not  need  to  be  edu- 
cated toward  a  viewpoint  more  satisfactory  to  those  who 
are  trying  to  familiarize  the  public  with  osteopathic  princi- 
ples. 

It  is  true  that  the  medical  profession  does  not  have  to 
advertise  in  an  open  manner,  but  the  greatest  publicity 
campaign  known  is  carried  on  day  by  day,  month  by  month, 
and  year  by  year,  in  a  manner  that  does  not,  in  any  way, 
have  the  appearance  of  being  advertising  matter.  The 
papers  and  magazines  almost  monthly,  and  the  dailies, 
daily,  contain  from  one  to  three  or  four  articles  directly 
or  indirectly  discussing  some  health  matter,  or  some  disease, 
under  a  special  column,  or  mentioning  some  epidemic  where 
certain  serums  have  been  found  to  relieve  certain  condi- 
tions; and  by  the  end  of  the  year,  you  will  find  the  sum  total 
of  this  insidious  publicity  campaign  work  will  amount  to 
sufficient  material  in  any  one  locality  to  make  a  good  sized 
volume. 

We  have  not  yet  reached  the  stage  where  we  can  get 
the  ear  of  the  press,  but  we  will  some  day,  and  until  we  can 
do  that,  it  is  up  to  us  to  use  the  best  literature  published, 
and,  in  an  ethical  manner,  secure  the  attention  of  those  who 
either  are  taking  treatment  or  will  eventually  be  interested 
in  osteopathy. 


ADVERTISING  233 

It  will  be  just  as  well  to  circulate  magazines  from  var- 
ious publishers  at  different  times.  For  instance,  a  couple 
of  hundred  osteopathic  magazines,  put  out  by  the  A.  O.  A., 
one  month;  and  the  O.  H.,  or  Williams'  brochures,  another 
month;  and  that  most  stable  magazine,  the  Herald  of  Os- 
etopathy,  which  is  one  of  the  oldest  osteopathic  publications 
and  which  has  brought  thousands  of  new  patients  to  the 
osteopaths'  offices. 

Each  doctor  can  select  his  own  reading  matter,  but  never 
think  that  you  are  doing  the  right  thing  until  you  have  used 
a  certain  amount,  at  least,  of  publications  that  explain  the 
principles  of  osteopathy  from  various  standpoints. 


CHAPTER  XXVII 


RESEARCH 


CHAPTER   XXVII. 

RESEARCH 

There  is  something  fascinating  about  research  work. 
Those  of  you  who  have  seen  that  famous  play  "The  Bird  of 
Paradise"  will  remember  distinctly  the  tremendous  feature 
in  one  of  the  scenes  wherein  a  graduate  medical  doctor  sup- 
posedly finds,  from  a  microscopical  viewpoint,  the  causa- 
tive factor  of  leprosy. 

To  my  mind  there  is  no  greater  point  of  interest  in  any 
physician's  life,  outside  that  of  a  grateful  patient,  than  the 
inventive  or  research  turn  of  mind  in  making  an  entirely 
new  discovery,  whether  it  be  a  causative  factor,  or  technic, 
administration  of  instruments  or  a  formula  that  is  useful 
to  a  patient  undergoing  operation  or  treatment. 

We  have  always  felt  that  every  physician  in  actual 
practice,  should  at  some  time  during  each  year,  accomplish 
at  least  one  thing  along  the  line  of  research  work;  and  this 
would  be  possible,  in  almost  every  instance,  if  physicians 
would  realize  that  research  development  takes  place  only 
after  one  has  concentrated  sufficiently  on  a  particular  sub- 
ject. 

Inventions,  as  a  rule,  do. not  come  out  of  the  blue  sky. 
We  may  be  inspired  by  Nature's  wonderful  touches,  and 
it  is  quite  possible  to  live  so  in  tune  with  Nature  that  we 
can  practically  draw  out  of  our  observations  while  in  touch 
with  Nature,  unusual  and  remarkable  thoughts  and  possibly 
discoveries;  but  the  greater  number  of  inventions  and  the 
greater  amount  of  research  work  accomplished  in  the  labora- 
tories, follows  only  a  tremendous  amount  of  study  and 
detail  work. 

—237— 


238  PRACTICAL  VISIONS 

It  does  seem  to  me  that  it  is  worth  while  to  try  and 
reach  a  point  where  we  can  touch  these  two  most  satisfactory 
phases  in  a  physician's  practice.  If  there  are  certain  propo- 
sitions to  be  handled,  and  certain  goals  to  be  reached  in 
order  that  we  may  receive  that  unusual  stimulation  that 
goes  with  touching  the  goal,  or  reaching  the  highest  point  of 
success,  in  the  way  of  research  findings,  why  not  set  out  to 
attain  this  high  and  unusual  point  of  vantage? 

If  every  graduate  of  an  osteopathic  college  would  follow 
out  the  resolutions  that  he  made  while  attending  college, 
it  would  not  be  very  long  before  he  would  have  a  thesis 
written  on  some  particular  disease  that  had  attracted  his 
attention  and  to  which  he  had  devoted  weeks  and  months 
of  constant  consideration  and  thought.  While  this  treatise 
might  not  be  anything  particularly  new,  yet  it  would  be  the 
beginning  of  a  great  ending,  and  I  absolutely  believe  that 
any  physician  who  will  start  out  in  this  manner  (taking  for 
granted  that  he  is  sufficiently  interested  in  any  one  sub- 
ject) and  work  through  to  an  end,  will  within  ten  years' 
time,  develop  some  new  idea  and  make  himself  almost  a 
specialist  on  that  particular  line  of  work. 

You  seldom,  if  ever,  hear  of  a  specalist  on  varicose  veins, 
for  instance,  yet  back  of  that  tremendous  physiological  per- 
version there  is  room  for  a  specialist  to  make  himself  famous 
the  world  over.  There  should  be  a  way  of  handling  vari- 
cosities,  although  possibly  indirectly,  from  a  vasomotor 
standpoint,  in  the  early  stages,  and  later  on  from  a  more 
or  less  mechanical  standpoint,  to  the  extent  that  the  phy- 
sician will  be  able  to  advise,  in  almost  every  instance,  a 
successful  method  of  handling  this  peculiar,  annoying  con- 
dition. 

Seldom  do  we  find  a  specialist  who  has  devoted  his 
entire  time  and  energy  to  the  subject  of  phlebitis,  yet  there 


RESEARCH  239 

is  a  direct  cause  in  almost  every  instance,  and  there  should 
be  a  specific  treatment.  While  we  have,  in  a  general  way, 
considered  both  of  these  conditions  from  an  osteopathic 
viewpoint,  and  while,  in  a  general  way,  our  books  cover  these 
two  diseases  from  a  technical  standpoint,  yet  we  have  never 
followed  through  sufficiently  to  bring  out  scientific  details 
to  the  extent  that  we  can  advise  minutely  the  administra- 
tion of  treatment  in  each  and  every  instance. 

We  might  go  on  through  all  of  the  various  diseases  and 
show  that  those  who  specialize  follow  a  certain  routine.  The 
majority  of  specialists  take  up  one  of  ten  diseases,  and  every 
one  is  sufficiently  familiar  with  these  that  we  need  not  name 
them.  About  the  first  thing  a  student  has  in  mind  when 
graduating  is  to  specialize  along  the  line  of  eye,  ear,  nose 
and  throat  work.  This  seems  a  very  inviting  field.  If  he 
is  not  so  inclined,  he  may  make  a  specialty  of  surgery.  Or 
he  will  specialize  on  genitourinary  troubles,  while  some 
of  the  lady  osteopaths  will  specialize  on  obstetrics. 

Few  of  our  osteopaths  venture  to  specialize,  for  instance, 
on  nephritis,  yet  in  ten  years'  time,  by  concentrated  effort 
and  research  work  along  the  line  that  osteopathy  indicates,  it 
would  make  a  man  famous  from  coast  to  coast. 

How  many  of  our  osteopaths  have  specialized  on  goi- 
ter, for  instance,  and  are  known  throughout  the  osteopathic 
profession  as  goiter  specialists? 

How  many  have  concentrated  their  entire  time  and 
energy  on  hepatic  disturbances,  or  even  splenic  disturb- 
ances? 

There  is  absolutely  room  for  specialists  along  these 
various  lines,  but  in  order  to  get  out  of  the  ordinary  routine, 
research  work  is  demanded  and  the  majority  of  our  grad- 
uates are  not  research  men — the  vast  majority,  I  say.  About 
one  in  a  hundred  has  a  tendency  towards  research  develop- 


240  PRACTICAL  VISIONS 

ment,  and  they  follow  the  lines  of  least  resistance.  They 
buy  all  of  the  books  published,  and  visit  the  reference  li- 
braries to  post  up  on  the  specialty  of  eye,  ear,  nose  and 
throat  work.  This  may  be  one  of  the  most  fascinating 
callings,  but  it  is  covering  the  ground  that  might  be  done 
by  those  who  have  no  inclination  along  research  lines. 

However,  in  our  osteopathic  field,  I  am  glad  to  say  that 
we  have  the  greatest  eye,  ear,  nose  and  throat  men  the  world 
has  ever  known.  The  names  of  some  of  our  osteopathic 
specialists  in  this  particular  line  will  go  down  in  history  as 
inventors  of  the  most  ingenious  methods  ever  conceived  by 
physicians. 

We  are  just  reaching  the  threshold  of  a  great  awakening 
along  the  line  of  research  work.  I  have  contended  for  years 
that  the  osteopathic  profession,  represented  by  our  National 
Association,  could  pull  off  no  greater  piece  of  work  some  one 
year,  than  that  of  a  research  year.  We  have  some  splendid 
research  workers,  who  have  been  at  this  line  of  work  for 
many  years,  and  we  have  some  splendid  laboratories;  but 
how  few  are  doing  the  actual  work!  We  want  to  dip  down 
into  the  colleges,  reaching  the  various  students,  and  creating 
in  then:  minds,  through  the  teaching  of  the  professors,  that 
peculiar  research  instinct  as  a  result  of  which  a  student  will 
so  thoroughly  ground  himself  in  the  idea  of  being  original 
that  when  he  is  graduated  and  goes  out  into  the  field,  he 
will  have  an  awakening  that  will  result  in  findings  that  were 
never  dreamed  of  before  the  research  idea  dawned  upon 
his  mind. 

If  we  are  going  to  devote  our  entire  lifetime  to  the 
therapeutic  art,  and  if  we  intend  to  put  our  whole  soul  and 
energy  into  the  work,  which  we  should  do  in  order  to  make 
a  success  of  it,  I  am  sure  that  there  are  sufficient  hours  in 
the  twenty-four  to  devote  at  least  a  few  thoughts  to  research, 


RESEARCH  241 

and  turn  our  attention  to  some  particular  phase,  hoping 
that  some  day,  out  of  our  study  and  concentrated  thought,  we 
will  produce  something  that  is  worth  while  to  humanity. 

How  is  the  world  going  to  progress  from  a  therapeutical 
standpoint,  unless  the  individual  doctor  will  arouse  himself 
and  become  sufficiently  interested  in  the  physical  welfare 
of  humanity  to  throw  his  energy  into  his  work  sufficiently 
to  bring  about,  or  develop,  the  creative  turn  of  his  mind, 
whereby  he  will  get  away  from  the  beaten  path,  and,  with 
a  more  thorough  knowledge  of  the  workings  of  the  human 
body,  bring  out  some  feature  that  has  never  been  known 
before  in  therapeutic  history. 

We  will  welcome  the  day  when  there  will  be  more  re- 
search men,  and  when  each  doctor  either  will  do  research 
work,  or  it  will  be  known  that  he  is  not  interested  in  it. 

We  hope  there  will  be  sufficient  interest  in  this  line  that 
patients  coming  to  a  physician  will  ask  him  from  year  to 
year  what  he  has  done  new  for  humanity.  This  will  indi- 
cate how  much  interest  he  is  taking  in  his  work,  and  how 
much  time  and  attention  he  has  devoted  to  that  particular 
phase,  wherein  something  new  will  be  turned  out  that  will 
be  of  value  to  suffering  humanity. 

There  are  some  physicians  who  devote  a  great  deal  of 
time  and  energy  to  speculative  measures,  or  to  the  social 
side  of  life.  There  are  others  who  are  over-studious,  but 
they  are  in  the  minority. 

The  well-rounded  physician,  who  attains  sufficient 
heights  to  be  known  as  an  outstanding  physician,  or  sur- 
geon, is  the  one  who  has  burned  the  midnight  oil  and  who 
knows  and  realizes  that  he  is  accomplishing  something  that 
is  unusual. 


(16) 


CHAPTER  XXVIII 


TREATING  CHILDREN 


CHAPTER  XXVIII. 

TREATING  CHILDREN 

Some  doctors  like  to  treat  children,  others  do  not. 
I  must  admit  candidly  that  I  practised  for  about  fifteen 
years  before  I  really  enjoyed  treating  a  child.  In  fact  I 
have  turned  away  many  a  child  because  it  cried  when  being 
examined,  and  I  just  did  not  want  to  bother  handling  that 
child  as  it  seemed  to  make  me  nervous.  For  some  unknown 
reason  I  changed  about  entirely,  and  at  the  present  time 
it  is  more  pleasure  in  almost  every  instance  to  treat  a  child 
than  an  adult.  I  have  a  great  fondness  for  children;  I 
dislike  seeing  them  handicapped  physically  and  I  thoroughly 
enjoy  seeing  them  restored  to  health. 

When  I  became  interested  in  infantile  paralysis,  I 
realized  that  in  order  to  test  out  the  merits  of  osteopathy 
in  these  cases,  it  would  be  almost  absolutely  essential  to 
conduct  a  free  clinic  in  that  we  could  hold  the  cases  for  the 
necessary  length  of  time  in  order  to  bring  about  the  restora- 
tion. From  this  reasoning  the  National  League  for  the 
Prevention  of  Spinal  Curvature  was  founded,  and  through 
it  a  great  many  clinics  have  been  established  over  the  coun- 
try, and  thousands  of  children  are  being  benefited  each  year 
and  likewise  the  doctors  have  benefited  by  the  experience, 
and  have  almost  invariably  more  faith  in  the  science  of  os- 
teopathy. 

We  also  found  that  another  reason  we  did  not  get  good 
results  in  treating  children,  was  not  only  that  we  had  not 
been  treating  them  for  a  sufficient  length  of  time  in  infan- 
tile paralysis  cases,  but  that  we  had  not  been  giving  them 
proper  adjustment.  Because  they  were  children  we  had 

—245— 


246  PRACTICAL  VISIONS 

the  idea  that  we  should  amuse  them,  tell  them  stories,  count 
their  toes,  knead  their  muscles  and  do  very  little  real  cor- 
rective work. 

In  our  great  clinic  where  we  treat  as  many  as  forty- 
eight  children  in  one  hour  and  twenty  minutes,  we  give  them 
not  only  specific  treatment,  but  use  a  great  deal  of  force 
in  thoroughly  springing  and  securing  motion  in  the  verte- 
brae in  the  various  regions.  We  did  not  think  at  first  that 
it  was  necessary  to  secure  a  strong  lumbar  rotation  as  well 
as  good  motion  in  the  lower  thoracic,  but  we  have  found 
that  a  good  stiff  treatment  is  quite  essential  if  we  desire 
to  secure  vasomotor  tone,  and  bring  back  to  a  normal  con- 
dition the  atrophied  muscles  in  the  legs  especially. 

Massage  will  bring  about  sufficient  effect  on  the  circu- 
lation to  warm  the  feet  temporarily,  but  in  half  an  hour's 
time  the  feet  will  turn  cold  again.  After  two  or  three  spe- 
cific treatments,  we  can  throw  the  circulation  to  the  feet 
that  were  once  cold  and  clammy  and  make  them  warm  for 
at  least  several  hours.  After  two  or  three  weeks'  treatment, 
the  mothers  will  remark  about  how  warm  the  feet  are  in 
contrast  to  their  being  so  cold  over  a  period  of  time  extend- 
ing back  to  the  convalescent  stage  when  the  child  was 
slowly  recovering  from  the  attack. 

We  likewise  give  a  thorough  adjustive  treatment  in 
the  cervical  as  well  in  the  upper  thoracic,  and  should  there 
be  muscle  atrophy  in  one  or  both  arms,  there  seems  to  be 
a  necessity  of  a  strong  specific  treatment  in  the  region  just 
referred  to.  Children  will  not  break,  and  if  you  are  well 
posted  in  your  technic,  you  will  not  injure  them,  but  you 
will  start  impulses  in  the  various  nerve  tracts  that  will 
awaken  the  various  circulations  and  bring  about  a  physio- 
logical activity  that  will  make  restoration  possible  in  the 
majority  of  instances. 


TREATING  CHILDREN  247 

If  you  have  no  particular  fondness  for  children,  and  they 
will  not  go  to  you  with  confidence,  you  are  absolutely  ex- 
cused from  trying  to  handle  these  cases,  but  if  you  can 
win  the  confidence  of  a  child  in  a  very  short  time,  by  all 
means  take  great  interest  in  the  children.  It  is  all  well 
and  good  to  treat  old  chronic  cases,  give  them  ease  or  re- 
store them  in  the  great  majority  of  instances,  but  is  it  not 
true  that  the  children  should  be  reached  and  brought  back 
to  normality  just  as  much  as  the  adults,  if  not  more  so? 

Were  it  possible  to  eradicate  all  cases  of  scoliosis  by 
semi-annual  inspection  and  adjustment,  it  would  be  but 
a  few  years  before  we  would  have  but  few  chronic  cases  in 
adults  to  bring  back  to  normal.  What  a  different  world 
this  would  be  if  the  osteopaths  could  carry  on  this  special 
semi-annual  work  and  train  the  children  in  such  a  manner 
that  whatever  ailment  came  upon  them  later  on  in  life,  they 
would  have  speedy  adjustment  and  quick  restoration. 

We  are  keenly  interested  in  clinics.  We  cannot  under- 
stand why  any  osteopath  living  should  not  either  have  a 
personal  clinic  or  work  in  a  group  clinic.  It  seems  to  me 
that  it  is  the  duty  of  every  osteopath  to  carry  on  in  some 
clinic.  There  are  a  number  of  osteopaths  who  will  say  that 
they  treat  children  free  occasionally  during  the  week,  but 
in  these  instances  no  particular  credit  is  given  such  as  might 
be  should  a  clinic  be  announced  and  the  mothers  of  the 
neighborhood  have  their  attention  drawn  to  the  fact  that 
a  clinic  is  really  being  conducted,  and  that  other  children 
are  welcome,  and  that  the  doctor  is  known  as  one  who  is 
willing  to  work  in  a  clinic  without  remuneration. 

It  is  this  concentrated  action  that  not  only  benefits 
those  that  are  being  treated,  but  also  gives  a  backing  to  os- 
teopaths that  cannot  be  equalled  in  any  other  respect.  When 
you  once  have  the  mothers  of  a  neighborhood  or  in  a  town 


248  PRACTICAL  VISIONS 

talking  for  you,  you  are  accomplishing  something  that  will 
last  for  years.  Cases  will  be  sought  out  by  these  interested 
mothers,  where  parents  are  unable  to  pay  for  treatment,  and 
you  will  be  surprised  at  the  keen  interest  these  mothers  take 
in  bringing  in  a  neighbor's  children  to  have  them  brought 
back  to  normal. 

We  hope  that  in  the  next  few  years  the  osteopaths  all 
over  the  land  will  have  established  not  only  one  hundred  and 
sixty  clinics  as  there  are  at  the  present  time,  but  two  or  three 
thousand  clinics.  When  this  is  accomplished,  we  will  point 
with  pride  to  what  osteopathy  is  doing  all  over  the  land,  and 
we  will  have  a  better  class  of  people  physically,  and  the  world 
will  move  more  smoothly  because  we  have  done  our  bit. 

It  takes  time  to  treat  a  case  of  infantile  paralysis  where 
a  child  has  been  wearing  a  brace,  or  going  about  on  crutches, 
or  has  been  in  a  cast  for  some  length  of  time  and  possibly 
undergone  an  orthopedic  operation  on  the  tendo  achilles, 
but  it  is  certainly  amazing  to  see  the  results  that  may  be  ob- 
tained if  we  are  sufficiently  persistent  and  interested  in 
the  children's  welfare.  It  may  take  six  months,  or  possibly 
a  year,  but  I  will  frankly  state  that  I  have  treated  these  cases 
two  years  in  the  free  clinic  and  have  been  almost  invariably 
rewarded  by  observing  that  the  child  was  again  almost  nor- 
mal in  every  respect.  Ninety  percent  of  these  cases  can  be 
restored  if  they  are  not  too  chronic;  the  other  ten  per  cent 
can  be  benefited. 

I  have  never  as  yet  seen  a  case  of  infantile  paralysis  that 
could  not  be  benefited  by  osteopathy.  If  the  time  ever 
comes  when  we  will  be  allowed  to  take  the  acute  cases,  there 
will  be  so  few  cripples  in  this  land  that  we  will  simply  be 
amazed.  Unfortunately,  there  are  those  who  think  that 
other  methods  than  manipulative  are  the  proper  thing  in 
the  acute  stages.  The  few  cases  that  we  have  been  able  to 


TREATING  CHILDREN  249 

handle  in  one  way  or  another  while  in  the  acute  stage,  have 
proven  to  us  most  conclusively  that  the  greatest  treatment 
in  the  world  for  acute  conditions  is  specific  osteopathic  meas- 
ures. 

A  two-minute  adjustment  will  reduce  the  fever  even 
in  an  infantile  paralysis  case,  and  the  child  that  has  been 
tossing  on  its  bed  and  contorting  itself  in  that  feverd  condi- 
tion will  lie  quietly  and  sleep  for  at  least  short  intervals,  and 
in  two  or  three  days'  time  through  the  absence  of  the  ex- 
cessively high  fever,  very  little  damage  will  have  been  done 
to  the  motor  areas  of  the  spinal  cord.  The  old  idea  of  allow- 
ing these  cord  segments  to  burn  out  and  then  stating  that 
there  is  no  possibility  of  restoration  because  they  have  burn- 
ed out,  is  most  fallacious  to  say  the  least.  The  most  impor- 
tant time  to  check  this  great  destruction  is  undoubtedly  at 
the  time  when  the  fevered  condition  can  be  controlled. 
Were  we  not  familiar  with  specific  nerve  centers,  and  did  we 
not  understand  how  these  centers  control  the  circulation 
over  the  body,  we  would  be  entirely  unable  to  secure  any 
results. 

Massage  is  absolutely  contra-indicated  in  these  early 
stages,  as  the  three  circulations  should  not  be  churned  up, 
but  if  specific  adjustment  could  last  but  half  a  minute  or 
even  a  quarter  of  a  minute,  regulating  the  nerve  impulses, 
it  may  save  the  child  from  years  of  suffering  and  restore  it  to 
normal  health. 

Pay  more  attention  to  the  children;  learn  how  to  get 
their  confidence  and  give  them  stronger  treatments  with 
less  muscle  kneading,  and  you  will  be  pleased  with  the  re- 
sults you  get,  and  the  clinic  that  you  will  start,  if  you  have 
not  already  entered  into  one,  will  add  to  your  pleasure  as  a 
physician,  and  at  the  close  of  each  year  you  will  feel  that  you 
have  done  something  for  humanity  that  will  live  after  you. 


CHAPTER  XXIX 


OFFICE  ATTENDANTS 


CHAPTER  XXIX. 

OFFICE  ATTENDANTS 

There  are  a  few  very  important  points  which  concern 
every  practitioner,  and  one  of  the  chief  of  these  is  the  selec- 
tion of  the  attendants  in  his  office. 

We  have  taken  for  granted  that  you  have  selected  a 
most  desirable  suite  of  office  rooms  in  the  down  town  dis- 
trict, and  that  you  desire  to  make  the  proper  impression 
upon  your  patients  as  they  enter  and  leave  your  office; 
also  that  you  consider  from  a  business  standpoint  as  well, 
the  value  of  proper  attendants. 

First,  there  is  no  question  in  my  mind  but  that  a  grad- 
uate nurse  is  of  more  value  to  an  office  than  the  average 
physician  would  naturally  think.  We  have  had  in  our 
office  continually  for  fifteen  years,  a  graduate  nurse.  She 
has  always  been  dressed  in  uniform.  There  is  something 
about  the  presence  of  a  nurse  that  inspires  confidence  in 
your  lady  patients,  and  if  you  have  selected  well,  you  will 
find  that  there  are  a  great  many  things  that  the  nurse  can 
answer,  thus  relieving  you  of  a  number  of  the  lesser  duties. 
For  instance,  a  graduate  nurse  is  supposed  to  be  well  posted 
on  the  subject  of  diet,  the  giving  of  enemas,  douches,  and 
a  number  of  minor  points  which  are  so  valuable  to  the  in- 
quiring patient. 

If  the  nurse  is  of  the  right  sort,  she  wDl  make  friends 
with  the  lady  patients,  who  will  ask  her  many  questions, 
and  she  will  be  able  to  give  them  the  desired  information. 
Suppose  a  case  is  being  treated  that  has  been  used  to  the 
taking  of  laxatives,  and  a  more  natural  substitute  could  be 
given,  I  find  it  well  to  give  a  simple  bit  of  instruction  to 

—253— 


254  PRACTICAL  VISIONS 

the  nurse  as  to  how  to  prepare  some  food  that  acts  as  a 
laxative,  or  how  to  mix  bran  so  that  it  will  have  the  desired 
effect  upon  the  alimentary  tract,  also  the  proper  way  to 
take  an  enema,  the  use  of  the  high  colon  tube  for  high  ene- 
mas and  the  antiseptic  solutions  used  in  douches.  These, 
and  a  great  number  of  other  things  which  she  will  describe 
to  the  patients,  relieve  me  of  that  amount  of  detail. 

Suppose  you  open  an  office  in  a  small  town  of  say  five 
thousand.  You  will  ask  if  I  would  recommend  a  nurse  in 
that  instance.  By  all  means  I  would,  even  if  it  is  a  place 
of  only  two  thousand.  A  nurse  will  give  tone  to  your  office 
more  than  you  can  imagine.  She  will  be  part  of  the  office 
staff  and  the  intelligent  replies  that  she  will  give  over  the 
phone  to  questions  pertaining  to  periods  and  so  forth, 
can  all  be  very  nicely  handled  and  with  that  delicacy  that 
goes  with  proper  training  and  understanding. 

Depending  on  the  size  of  your  practice,  the  number  of 
attendants  may  be  regulated  according  to  the  amount  of 
work  that  is  to  be  done.  Appointments  must  be  made  and 
the  nurse  must  understand  your  capacity  to  handle  patients 
according  to  their  various  ailments.  We  use  no  regularity 
in  the  length  of  treatment.  Each  case  is  individual  in  it- 
self. When  she  becomes  accustomed  to  your  methods  of 
handling  cases  and  understands  that  you  can  handle  more 
cases  on  certain  days  than  on  others,  and  that  certain  cases 
need  less  time  than  others,  you  will  find  that  her  co-opera- 
tion will  greatly  assist  you  in  determining  just  how  much 
you  can  accomplish. 

If  there  is  a  great  deal  of  letter  writing  to  be  done  and 
if  you  acquire  the  habit  of  contributing  to  one  or  more  jour- 
nals, you  will  necessarily  have  to  employ  a  stenographer 
more  or  less  continuously.  If  you  do  a  great  deal  of  work, 
you  may  need  two,  but  all  letters  should  be  answered  the 


OFFICE  ATTENDANTS  255 

same  day  they  are  received  and  all  letters  should  be  type- 
written. It  is  an  imposition  to  expect  a  busy  doctor  to 
wade  through  a  longhand  letter  and  reply  to  it  on  the  same 
day.  A  neatly  typed  letter  is  usually  a  pleasure  to  read, 
and  likewise  calls  for  a  similar  response. 

The  nurse  can  handle  the  greater  amount  of  the  work; 
she  can  likewise  look  after  the  collecting  of  the  fees.  It 
is  certainly  easier  not  to  keep  books  or  run  accounts,  and 
to  run  your  business  on  a  cash  system.  There  is  all  the 
difference  in  the  world  at  the  end  of  the  year  between  a 
practically  clean  sheet  in  one  instance  and  a  loaded,  doubt- 
ful, sheet  in  another.  Have  your  patients  pay  at  the  time 
of  each  treatment  and  you  will  find,  as  a  rule,  it  is  much 
more  satisfactory. 

Regarding  appointment  sheets:  When  we  first  entered 
practice  we  used  the  ordinary  blank  that  is  used  by  the 
majority,  and  as  nearly  as  I  remember,  appointments  were 
thirty  minutes  apart.  I  believe  at  the  present  time  they 
have  sheets  that  provide  for  fifteen  minute  treatments. 
We  started  printing  our  own  appointment  sheets.  The  first 
contained  about  twenty  a  day  and  the  second  about  forty, 
and  several  years  ago  we  worked  out  a  sheet  that  contained 
a  little  over  sixty  a  day.  We  have  now  abandoned  the  ap- 
pointment sheet  entirely.  We  find  there  is  a  little  psychol- 
ogy about  a  doctor's  office  as  well  as  about  a  business  man's 
house. 

There  are  times  when  everybody  wants  to  come  at  the 
same  time  and  it  seems  as  if  everybody  wants  to  come  that 
very  same  day.  Here  is  where  a  level  headed  nurse  will  be 
able  to  assist  greatly  in  equalizing  matters  by  using  her 
rare  judgment  regarding  psychological  propositions.  It 
may  mean  that  the  doctor  will  have  to  be  a  little  more  alert, 
a  little  more  active  and  expend  a  bit  more  energy  for  that 


256  PRACTICAL  VISIONS 

particular  day.  If  you  have  at  least  five  treatment  rooms, 
you  can  handle  a  goodly  number  and  by  a  little  tact  you 
can  treat  those  who  are  in  the  greatest  hurry.  Here  is 
another  advantage  in  giving  specific  treatment.  There 
are  some  cases  that  will  take  only  two  minutes,  while  others 
require  six  minutes  and  occasionally  a  case  may  take  ten. 

We  will  pause  here  for  a  minute  and  answer  a  question 
that  is  so  frequently  asked.  How  can  you  handle  a  chronic 
case  that  has  a  great  variety  of  symptoms,  and  diseased 
organs,  and  give  a  treatment  that  lasts  but  a  few  minutes? 
This  will  bring  up  the  great  lymphatic  proposition  again, 
and  in  brief,  we  would  state  that  the  more  complicated  the 
case,  the  more  specific  the  treatment  should  be.  For  ex- 
ample,  we  will  take  a  case  of  inflammatory  rheumatism, 
where  the  patient  is  so  extremely  sensitive  that  it  is  almost 
impossible  to  handle  extremities,  for  instance,  without 
causing  a  great  deal  of  pain. 

Years  ago  I  remember  of  trying  to  give  a  most  general 
treatment  in  these  particular  cases,  and  I  found  that  the 
treatment  was  almost  more  than  the  patient  could  stand. 
I  got  to  reasoning  along  the  line  of  bodily  functionings  and 
eventually  it  dawned  upon  my  mind  that  in  giving  general 
treatment,  I  was  churning  the  entire  fluids  of  the  body  un- 
duly. I  found  that  where  treatment  could  be  given  only 
once  or  twice  a  week,  by  giving  specific  treatment  according 
to  the  edematous  areas  found,  I  could  get  much  better 
results,  secure  better  drainage  and  get  my  patient  out  in 
much  quicker  time.  Where  there  seemed  to  be  a  great  deal 
of  inflammation  in  the  lower  extremities,  for  instance,  I 
would  confine  my  first  two  or  three  treatments  to  springing 
the  lower  thoracic  and  lumbar  region  with  the  patient  on  his 
back,  reaching  over  the  body,  catching  the  spinous  pro- 
cesses with  the  tips  of  the  fingers  and  springing  forcibly 


OFFICE  ATTENDANTS  257 

upward.  If  there  seemed  to  be  any  blockage  in  the  terminal 
lymphatic  ducts,  a  specific  upper  thoracic  adjustment,  and 
forcible  springing  of  the  outer  ends  of  the  clavicles,  would 
relieve  the  condition  sufficiently.  The  fluids  of  the  body 
would  become  more  or  less  equalized  as  the  kidneys  became 
more  active  and  the  terminal  drainage  more  perfect. 

Why  give  a  general  treatment  in  these  conditions  when 
a  specific  treatment  will  be  of  more  benefit  and  not  tax  the 
patient  to  the  same  extent?  There  are  many  other  diseases 
wherein  various  organs  are  affected,  and  we  would  likewise 
advise  specific  adjustment  in  order  to  restore  the  condition 
to  normal  in  the  shortest  possible  time. 

It  takes  years  to  figure  out  this  one  proposition,  and 
had  I  known  this  very  point  when  I  first  began  practising, 
I  might  have  saved  myself  a  great  deal  of  trouble  and  anxiety, 
and  at  the  same  time  have  been  of  more  benefit  to  the 
patients  under  my  care. 

We  cannot  expect  a  young  graduate  to  have  had  the 
experience  that  a  doctor  who  has  been  practising  for  a  decade 
or  more  has,  but  there  is  such  a  thing  as  profiting  by  the 
experience  of  others,  and  the  majority  of  doctors  are  per- 
fectly willing  to  be  advised  and  instructed,  and  after  all, 
the  greatest  proposition  in  osteopathy  is  how  to  handle  your 
patient  in  a  manner  that  will  enable  you  to  secure  the  quick- 
est possible  results. 

After  practising  almost  twenty-three  years,  I  am  still 
learning  something  each  day  and  my  work  is  becoming 
more  specific  from  time  to  time  in  that  I  feel  that  I  can 
accomplish  more  and  secure  better  results  by  following  more 
closely  the  teachings  of  Dr.  A.  T.  Still.  When  I  think  how  a 
man  could  put  before  the  world  a  new  science,  and  give  to 
his  students  details  as  he  did  regarding  the  various  points 
that  have  been  discussed  in  this  and  other  chapters,  I  am 

(17) 


258  PRACTICAL  VISIONS 

simply  amazed  at  the  resourcefulness  of  this  blazer  of  a 
new  trail. 

It  has  taken  me  many  years  to  learn  things  that  I  re- 
member distinctly  hearing  the  Old  Doctor  state,  but  at  the 
time  did  not  appreciate.  We  seemed  to  think  at  the  time 
he  was  talking,  that  his  peculiar  way  of  doing  things  could 
not  be  applied  to  ours,  and  had  I  the  privilege  of  living  over 
those  days  and  listening  to  him  again,  knowing  what  I 
do  now,  I  should  assume  an  entirely  different  attitude,  and 
I  believe  that  I  should  accept  what  he  said  and  put  it  into 
immediate  practice. 

True  it  is  that  all  students  going  through  college  listen 
to  the  same  lectures,  watch  the  same  clinical  demonstra- 
tions and  have  in  mind,  apparently,  the  various  nerve 
centers  that  control  the  functionings  of  the  human  body. 
But  it  is  a  different  proposition  entirely  to  be  out  in  the 
field,  thrown  upon  your  own  resources  and  confronted  with 
a  case  of  typhoid  fever.  For  instance,  try  to  put  into  prac- 
tice what  you  have  been  taught  regarding  adjustment  and 
the  control  of  the  various  parts  of  the  body  through  nerve 
centers,  that  were  outlined  in  the  lecture  room. 

I  know  personally  of  two  juniors  spending  their  holi- 
days years  ago  in  a  small  town  where  an  osteopath  was  taken 
down  with  typhoid  fever.  His  temperature  was  high  and 
apparently  it  was  a  typical  case;  all  symptoms  were  mani- 
fested. These  two  students  had  great  confidence.  They 
were  reasonably  sure  that  they  could  control  the  fever  in 
a  very  short  time.  They  had  listened  to  lectures  regard- 
ing the  reduction  of  fever  in  a  quarter  of  an  hour  or  less,  and 
immediately  they  began  working  on  the  vasomotor  nerve 
centers  that  would  supposedly  reduce  the  fever.  After 
working  some  two  or  three  hours  intermittently,  they  real- 
ized that  they  were  making  no  headway.  No  other  grad- 


OFFICE  ATTENDANTS  259 

uate  osteopath  was  within  one  hundred  miles.  They  felt 
their  helplessness  and  called  in  an  old  school  physician  and 
the  usual  drugs  were  given  to  reduce  the  fever.  It  still  did 
not  abate. 

The  wife  of  the  osteopath  sent  a  messenger  personally 
the  hundred  miles  and  presented  the  case  to  an  osteopath, 
who,  by  the  way,  was  an  extremely  busy  One,  and  with  that 
magnanimous  spirit  that  the  majority  of  physicians  have, 
or  should  possess,  this  doctor  took  the  first  train  and  arrived 
within  two  or  three  hours'  time  after  the  interview. 

Within  five  minutes  after  his  specific  adjustment,  the 
temperature  began  to  drop.  He  had  corrected  a  most 
specific  lesion  which  the  students  had  overlooked.  They 
were  depending  more  upon  inhibition,  as  we  used  to  call 
it,  and  manipulation  of  the  muscles. 

The  five  minutes'  treatment  that  this  doctor  gave  in  a 
most  specific  manner,  changed  the  entire  course  of  the  ail- 
ment, and  the  result  was  that  the  patient  was  up  and  around 
in  a  little  over  three  weeks'  time;  otherwise,  had  the  tem- 
perature remained  high  for  a  few  hours  longer,  there  might 
have  resulted  a  toxic  condition  that  would  have  caused  the 
patient  to  remain  more  or  less  convalescent  four  or  five  weeks 
after  the  fever  was  at  its  highest. 

This  brings  out  the  idea  that  we  have  stated  elsewhere, 
that  no  short  course  in  anatomy,  physiology,  pathology  and 
so  forth  is  sufficient  for  any  man  in  handling  the  various 
ailments  of  the  human  body.  Likewise,  we  cannot  expect 
of  a  senior  what  we  would  expect  of  a  graduate,  and  we 
cannot  expect  of  a  new  graduate  what  we  might  expect  of 
a  man  who  has  been  practising  ten  years  or  more.  How- 
ever, there  are  new  graduates  who  are  more  capable  of 
handling  cases  than  some  practitioners  who  have  been  out 
in  the  field  ten  years.  It  is  all  in  the  man,  his  vision  and  his 


260  PRACTICAL  VISIONS 

peculiar  understanding  of  the  human  body  from  a  mechan- 
ical standpoint. 

There  are  many  points  of  advice  to  be  given  to  patients 
each  day;  there  are  many  questions  to  be  answered  regard- 
ing osteopathy  and  the  various  diseases  that  we  are  supposed 
to  handle  and  there  are  times  when  a  patient  would  like  to 
ask  regarding  some  other  member  of  the  family.  Where  you 
have  free  clinics,  you  will  find  the  mothers  asking  many 
more  questions  regarding  the  health  and  care  of  their  little 
ones. 

The  nurse's  attention  is  given  free  as  well  as  that  of 
the  doctor.  We  have  never  made  any  charges  yet  in  the 
free  clinic.  We  give  them  every  attention  that  we  do  our 
best  pay  patients,  and  every  consideration  is  shown  the 
mothers  that  is  shown  the  wealthiest  patrons  we  have. 
The  nurse  dresses  in  uniform  for  the  clinics  the  same  as  she 
does  for  regular  patients,  and  that  is  possibly  the  reason 
why  some  clinics  are  much  better  attended  than  others. 

We  try  never  to  disappoint  our  free  clinic  patients  in 
the  way  of  being  late  any  more  than  we  would  our  regular 
patients.  They  should  not  be  kept  waiting  any  longer 
than  a  regular  patient.  It  resolves  itself  into  this:  What- 
ever you  do,  do  well.  If  you  do  not  care  to  do  it  well,  do 
not  do  it  at  all. 

The  mothers  of  children  in  the  free  clinics  are  often 
much  more  alert  and  ask  many  more  pertinent  questions 
than  do  the  mothers  who  pay  well  for  their  treatment.  The 
poor  class  have  been  thrown  around  from  one  clinic  to  an- 
other until  they  are  pretty  well  posted  regarding  certain  con- 
ditions, and  they  are  perfectly  able  to  ask  questions  that 
will  often  puzzle  you  if  you  are  not  absolutely  posted  and 
on  the  alert. 

Here  again  the  nurse  comes  in  very  handy  in  being  of 


OFFICE  ATTENDANTS  261 

great  assistance  to  the  mothers  who  bring  their  children  to 
the  free  clinic  for  attention.  You  may  not  think  it,  but 
there  are  people  in  every  city  where  clinics  are  held,  who  will 
encourage  children  to  go  to  the  clinics  just  to  try  out  the 
doctor  and  see  what  he  can  accomplish,  and  if  a  physician 
gets  satisfactory  results,  they  will  go.  I  have  seen  this 
done  many  a  time,  and  that  is  one  reason  why  we  pay  such 
particular  attention  to  all  of  our  clinic  cases.  A  physician 
with  a  large  practice,  well  known  in  a  city,  is  invariably 
watched  by  some  one  in  every  case  he  is  treating,  and  soon- 
er or  later  you  will  hear  directly  or  indirectly  that  you  have 
made  good  or  failed  in  some  case  that  you  thought  no  one 
had  under  observation. 


CHAPTER  XXX 


ATTITUDE  OF  A 

PHYSICIAN  TOWARD 

A  PATIENT 


CHAPTER  XXX. 

ATTITUDE  OF  A  PHYSICIAN  TOWARD   A 
PATIENT 

The  best  known  diagnostician  in  the  New  England 
States  was  called  on  a  case  a  few  years  ago,  one  stormy 
night,  and  the  husband  of  the  patient,  not  having  seen  the 
famous  doctor  before,  was  not  at  all  pleased  with  the  first 
words  uttered  by  the  doctor,  and  ordered  him  to  go  home, 
saying  that  he  would  not  have  him  treat  a  cat  of  his. 

Now,  to  my  mind,  it  is  not  always  a  matter  of  person- 
ality, and  it  is  impossible  for  any  physician,  no  matter  how 
high-standing  in  his  profession,  to  satisfy  patients,  or  even 
friends  and  relatives,  at  all  times. 

One  of  the  best  diagnosticians  in  Canada  is  a  little  man 
who  could  walk  under  the  arm  of  a  well-developed  man,  and 
yet  more  people  consult  him  in  the  course  of  year's  time  than 
any  three  or  four  other  specialists  put  together.  Appear- 
ance is  not  everything,  though  it  goes  a  long  way  in  some  in- 
stances, and  it  is  often  from  a  peculiar  standpoint  that  some 
physicians  express  themselves  to  their  patients. 

Lou  Tildes'  painting,  "The  Doctor,"  which  hangs  in 
the  majority  of  physicians'  offices  and  is  known  the  world 
over,  represents  the  typical  doctor  of  the  Old  School.  In 
this  day  and  age,  the  majority  of  physicians  do  not  dress  as 
they  did  in  those  days,  nor  consider  it  essentially  ethical 
or  necessarily  high-type  to  wear  a  full  beard.  Some  day 
a  modern  artist  may  paint  in  colors  on  a  canvas  the  supposed- 
ly modern  physician;  but  I  dare  say  it  would  be  much  more 
difficult  at  the  present  time  to  give  the  people  a  picture  of 
a  typical  physician  than  it  was  in  those  days  when  there 

—265— 


266  PRACTICAL  VISIONS 

seemed  to  be  certain  characteristic  features  that  made  the 
doctor  most  distinctive  in  type,  enabling  the  people  almost 
invariably  to  point  out  a  physician  in  any  gathering.  Some 
of  the  best  surgeons  at  the  preseut  time  could  walk  through 
a  crowd  or  sit  in  an  assembly  hall,  and  it  would  be  almost 
impossible  for  any  one  but  a  mind-reader  or  detective  to 
decide  who  was  a  physician. 

We  have  some  business  men  at  the  present  who  have 
the  appearance  of  physicians,  and  who  possibly  have  better 
judgment  in  dealing  with  men  and  women,  than  some  phy- 
sicians have.  A  keen  business  head  nowadays  must  be  a 
psychologist;  must  be  able  to  read  people;  and  with  a  little 
extra  training  in  the  way  of  diagnosing,  he  might  make  as 
good  a  physician  as  some  who  are  posing  as  specialists. 

Fifty  percent  of  the  success  in  healing  ordinary  cases 
depends  on  the  first  second  of  a  doctor's  meeting  with  a 
patient,  especially  if  the  patient  be  a  woman.  If  it  is  an 
emergency  case,  it  is  quite  different.  The  patient,  in  that 
instance,  is  glad  to  have  relief  of  any  kind,  and  she  will  have 
general  confidence  in  whoever  is  brought;  but  in  consulting 
a  prominent  physician,  or  diagnostician,  the  moment  the 
doctor  enters  the  home,  or  the  patient  enters  the  consulting 
room,  he  will  be  sized  up  and  much  of  his  success  in  handling 
the  case  will  depend  upon  the  result  of  the  first  impression. 
Conservatively  speaking,  fifty  percent  of  success  in  handling 
the  case  will  depend  on  the  first  impression. 

At  the  same  time,  whether  the  patient  knows  it  or  not, 
the  physician  is  likewise  summing  up  the  patient,  and  we 
hope  some  day  to  bring  out  a  book,  which  we  have  had  in 
mind  for  years,  that  may  interest  the  laity,  in  that  it  will 
give  somewhat  of  an  idea  as  to  the  amount  of  knowledge  a 
physician  may  obtain  by  simply  taking  one  glance  at  a  pa- 
tient. There  are  physicians  who  could  sit  down  and  write 


ATTITUDE  TOWARD  A  PATIENT  267 

a  three  hundred  page  book  on  what  they  observed  in  a 
patient  in  ten  seconds'  time.  Had  we  space  in  this  book, 
we  would  write  a  chapter,  just  to  indicate  what  we  refer  to. 

A  physician  is  trained  year  in  and  year  out  to  be  a  phys- 
ical detective.  Every  move  that  a  patient  makes  means 
something  to  the  physician.  Every  wink  of  the  eyelid 
suggests  certain  nervous  symptoms.  Every  facial  expres- 
sion gives  the  physician  a  clue  as  to  the  condition  of  the  cen- 
tral nervous  system.  The  shaking  of  the  hand  indicates 
vasomotor  tone,  or  lack  of  it.  The  feel  of  the  skin  on  the 
hand  also  speaks  a  volume. 

So  on  and  so  forth  we  might  outline  what  we  wish  to 
present  some  time;  but  we  will  confine  the  discussion  in  this 
chapter  to  the  theme  the  title  indicates. 

The  first  meeting  of  physician  and  patient  is  a  peculiar 
proposition.  We  do  not  wish  to  discuss  psychotherapy, 
psycho-analysis,  or  even  phychic  phenomena.  Neither  do 
we  care  to  discuss  possibilities  in  the  way  of  suggestive  thera- 
peutics, new  thought,  mental  healing,  or  any  other  of  the 
various  propositions  that  are  being  discussed  so  much  at 
the  present  time.  ^ 

We  must  appreciate  the  fact  that  is  it  practically  a 
matter  of  the  meeting  of  the  positive  and  the  negative,  for 
the  physician  is  or  should  be  a  great  positive  force,  with 
full,  complete,  command  and  control  of  himself,  in  that  he 
is  usually  too  busy  and  knows  too  much  to  be  sick,  and, 
being  well,  he  faces  the  patient,  a  weak,  frail,  sick,  and  nega- 
tive individual,  and  probably  frightened  besides.  There- 
fore, the  practitioner,  coming  into  contact  with  the  patient 
for  the  first  time  in  this  mental  relationship,  finds  it  axiom- 
atic, that  fifty  percent  of  his  success  depends  upon  the  first 
second  of  mental  contact. 

Following  the  order  used  in  the  greatest  institutions, 


268  PRACTICAL  VISIONS 

it  is  invariably  better  for  some  one  in  the  doctor's  office  to 
interview  the  patient  first,  and  a  nurse  is  the  best  beginning 
that  we  know  of.  We  will  consider  now  a  private  physi- 
cian's office,  and  not  a  group  clinic  where  a  number  of  doc- 
tors make  separate  diagnostic  records  before  the  head  phy- 
sician is  consulted. 

In  your  own  private  office  the  nurse  will  be  able  to  give 
the  patient  all  necessary  instructions,  answer  questions  per- 
taining to  treatment,  and  prepare  her  for  the  meeting  with 
the  doctor.  The  doctor  enters  in  a  quiet,  unassuming  man- 
ner, and  becomes  acquainted  with  the  patient  first,  thus  sav- 
ing his  own  energy,  and  the  timidity  on  the  part  of  the  pa- 
tient will  soon  be  overcome.  If  the  case  is  a  nervous  type, 
the  physician  will  make  no  headway  unless  he  can  secure 
the  confidence  of  his  patient.  We  refer  particularly  to 
women  patients  who  are  often  of  a  nervous  type,  and  all 
physicians  have  a  great  many  of  them.  The  patient  must 
realize  that  the  physician  is  master  of  the  situation,  well- 
posted  in  his  work,  and  absolutely  interested  in  the  case. 
This  idea  held  by  the  patient  will  inspire  confidence. 

Osteopathic  physicians  should  realize  that  the  human 
being  individually  is  not  only  an  animated  anatomy,  or 
physical  machine,  but  something  beyond  and  above  that — 
a  soul.  We  may  not  understand  what  this  peculiar  principle 
is.  We  may  not  all  agree,  from  a  physiological  standpoint; 
but  there  are  many  cases  that  come  under  our  observation 
that  must  be  treated  partly  at  least  by  suggestion,  or  in  some 
manner  that  will  rectify  worry  and  mental  impressions  that 
have  disturbed  the  nervous  equilibrium.  Every  physician 
should  be  sufficiently  posted  in  psychotherapy  and  sugges- 
tion to  enable  him  to  use,  discriminately  and  tactfully,  the 
proper  amount  of  suggestion,  so  that  the  patient  may  regain 
confidence  and  get  hold  of  himself  in  a  way  that  will  elimin- 


ATTITUDE  TOWARD  A  PATIENT  269 

ate  nervousness  and  dispel  alarm  that  may  be  improperly 
held  over  symptoms  and  conditions. 

There  is  one  other  point  we  would  like  to  emphasize. 
Ultimately,  physicians  must  realize  that  all  diseased  condi- 
tions leave  some  scar  on  the  mind  or  conscience  of  the  pa- 
tient. If  the  physician  is  sufficiently  posted  in  psycho- 
therapy to  drop  a  word  from  day  to  day,  while  treating, 
that  will  develop  the  mental  side  as  well  as  the  physical, 
the  patients  will  not  complain,  after  the  lesions  have  been 
corrected,  that  they  do  not  yet  feel  just  right  physically. 

The  mind  must  be  healed  as  well.  It  may  be  from  one 
standpoint,  or  it  may  be  from  another.  The  wise  physician 
is  the  one  who  will  sum  up  his  patient's  mental  attitude,  and 
deal  with  him  from  a  standpoint  that  will  appeal  to  him. 

CONCLUSION — Let  each  practitioner  look  upon  his  pro- 
fession as  an  exalted  one,  in  that  he  not  only  heals  through 
knowledge  of  the  wonderful  laws  of  the  body,  from  a  physi- 
cal standpoint,  but  that  he  fails  in  his  duty  to  man  when  he 
does  not  present  to  his  patient,  by  illustration  or  demonstra- 
tion, a  higher  level  of  life  and  an  idealism  that  the  patient 
must  follow  in  order  that  he  will  be  physically  and  mentally 
normal. 

After  all  lesions  have  been  corrected,  let  the  physician 
have  a  final  interview,  sit  down  and  tell  the  patient  some- 
thing like  this:  "Now  that  I  have  healed  your  body,  it 
is  principally  your  mind  that  will  keep  your  body  well," 
and  pointedly  tell  the  patient  that  unless  he  has,  besides  his 
trade  or  profession,  some  special  hobby  or  avocation,  of  a 
relaxing  and  inspiring  nature,  he  will  be  a  patient  forever, 
and  you  don't  want  that. 

There  comes  a  time  when  a  patient  must  depend  upon 
his  own  resources,  in  order  to  keep  himself  mentally  rounded 
out,  and  we  refer  to  the  mental  phase  as  one  of  nerve  equi lib- 


270  PRACTICAL  VISIONS 

rium,  and  the  patient  must  feel  eventually  that  he  is  more 
or  less  satisfied  with  his  own  conduct,  reasonings,  and  atti- 
tude towards  his  fellow  men. 

That  physician  will  have  accomplished  most  who  best 
trains  his  patients  to  be  mentally,  as  well  as  physically, 
normal. 

Joy  in  work  is  service  to  God  and  man! 

THE  END 


LYMPHATICS 

APPLIED  ANATOMY  and  TREATMENT 

By  F.  P.  MILLARD  and  a  Number  of  Other  Osteopathic 
Specialists 

About  70  half  tones,  including  specially  designed  drawings 
by  Millard.  Best  enameled  paper,  clear  type,  cloth  bound,  gilt 
lettering.  The  cost  of  cuts  in  some  single  chapters  amounts  to 
more  than  $40.00.  Dr.  Evelyn  Bush  has  a  chapter  on  "The 
Value  of  Exercises  on  the  Lymph  Stream."  (Twelve  Illustra- 
tions.) Dr.  Downing,  a  pioneer  in  lymphatics,  has  a  chapter 
from  the  Orthopedic  standpoint.  Drs.  Edwards,  Reid,  Deason, 
Collins,  Ashley,  Moore,  Snyder,  Bailey,  Laughlin,  and  several 
others,  have  chapters  on  different  phases  of  their  work  as  ap- 
plied to  lymphatics.  This  book  is  published  under  the  auspices 
of  the  International  Society  for  Lymphatic  Research. 

Price,  $6.00.     Send  orders  to 

F.  L.  LINK,  Kirksville,  Missouri 


THE  JOURNAL 

OF  THE  INTERNATIONAL  SOCIETY 
FOR  LYMPHATIC  RESEARCH 

Edited  by  F.  P.  MILLARD,  D.  O.,  Toronto. 

Associate  Editors:     J.  D.  EDWARDS,  M.D.,  D.O.;  C.  C. 

REID,  M.D.,  D.O.,  and  J.  DEASON,  M.S.,  D.O. 

A  quarterly  magazine,  brimful  of  the  latest  and  best  research 
findings  as  to  the  place  of  the  lymphatic  system  in  the  diagnosis 
and  treatment  of  disease.  Every  number  illustrated  with  origi- 
nal drawings  by  Millard. 

Subscription  included  with  membership  in  the  In- 
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Price  to  non-members  $2.00  a  year.  Address  International 
Society  for  Lymphatic  Research,  Kirksville,  Mo. 


INFANTILE  PARALYSIS 

Written  by  Osteopathic  Physicians.     Edited  by 
F.  P.  MILLARD,  D.  O. 

Dr.  Florence  Gair  has  two  interesting  chapters,  illustrated 
with  photographs,  of  cases  that  have  been  restored  to  normal  by 
osteopathic  methods.  The  book  contains  case  reports  from 
dozens  of  osteopathic  physicians.  It  is  written  for  the  laity 
as  well  as  for  the  osteopathic  practician,  and  contains  a  mint  of 
valuable  information  on  infantile  paralysis.  It  should  be  in 
every  home,  and  certainly  no  osteopath  should  be  without  it. 

Bound  in  Cloth  with  Gold  Title  Stamped  on  Cover 

Splendidly  Illustrated  Throughout  by  One  Hundred  Cuts 

Fourteen  Full-Page  Plates — Two  in  Colors 

The  book  contains  a  comprehensive  index  which  adds  greats 
ly  to  its  usefulness  and  value. 

COMMENTS  ON  BOOK 

I  have  just  gone  through  your  book  on  poliomyelitis.  I 
want  to  compliment,  you  on  writing  such  a  good  presentation 
of  the  subject.  It  is  timel>  and  strictly  osteopathic.  It  shows 
the  advance  of  therapeutics  along  this  line.  Your  chapter  on 
the  causes  and  applied  anatomy  of  the  diseape  are  worth  far 
more  than  the  price  of  the  book.  The  chapters  by  the  other 
writers  are  very  encouraging.  There  is  no  osteopath  in  the 
world,  but  who  ought  to  have  this  book  in  his  library. — C.  C. 
REID,  D.  O.,  M.  D. 

I  just  devoured  it  before  retiring  last  night.  It's  fine,  and 
I  hope  it  gets  a  good  sale. — E.  FLORENCE  GAIB,  D.  O. 

I  am  highly  pleased  with  it.  You  are  doing  good  work  for 
the  profession. — GEO.  W.  GOODE,  D.  O. 

I  enjoyed  your  book  on  infantile  paralysis.  I  have  shown 
it  to  all  of  my  patients.  Allow  me  to  congratulate  you.  Your 
name  will  live  in  medical  history  as  long  as  this  old  globe  lasts. — 
JAMES  D.  EDWARDS,  D.  O. 

Send  $4.00  to  F.  L.  LINK,  Kirksville,  Missouri,  at 
once  and  secure  a  copy  of  this  valuable  book. 


Date  Due 


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AN  2 


R  REC'D 


PRINTED  IN   U.S...  CAT       NO.      24      161 


Frederick  P 
tactical 


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1922 


Millard,  Frederick  P. 
Practical  visions 


MEDICAL  SCIENCES  LIBRARY 

UNIVERSITY  OF  CALIFORNIA,  IRVINE 
IRVINE,  CALIFORNIA  92664 


